Characterization of Traumatic Brain Injury Research in the Middle East and North Africa Region: A Systematic Review

Objectives: Traumatic brain injury (TBI) represents a major health concern worldwide with a large impact in the Middle East and North Africa (MENA) region as a consequence of protracted wars and conflicts that adversely affect the general population. Currently, systematic TBI studies in the MENA region are lacking, nonetheless they are immensely needed to enhance trauma management and increase survival rates among TBI patients. This systematic review aims to characterize TBI in the MENA region to guide future policy choices and research efforts and inform tailored guidelines capable of improving TBI management and patient treatment and outcome. Furthermore, it will serve as a road map to evaluate and assess knowledge of trauma impact on regional health systems that can be adopted by health-care providers to raise awareness and improve trauma care. Methods: We conducted a comprehensive search strategy of several databases including MEDLINE/Ovid, PubMed, Embase, Scopus, CINAHL, Google Scholar, and the grey literature in accordance with the PROSPERO systematic review protocol CRD42017058952. Abstracts were screened, and selected eligible studies were reviewed independently by 2 reviewers. We collected demographics information along with TBI characteristics, mortality rates, and regional distribution. Data were extracted using REDCap and checked for accuracy. Results: The search strategy yielded 23,385 citations; 147 studies met the eligibility criteria and were included in this review. Motor vehicle accident (MVA) was the leading cause of TBI (41%) in the MENA region, followed by the military- (15.6%) and fall- (8.8%) related TBI. Males predominantly suffer from TBI-related injuries (85%), with a high prevalence of MVA- and military-related TBI injuries. The TBI mortality rate was 12.9%. The leading causes of mortality were MVA (68%), military (20.5%), and assault (2.9%). The vast majority of reported TBI severity was mild (63.1%) compared to moderate (10.7%) and severe TBI (20.2%). Patients mainly underwent a Glasgow Coma Scale assessment (22.1%), followed by computed tomography scan (8.9%) and surgery (4.1%). Conclusions: Despite its clinical, social, and economic burden, the evidence of TBI research in the MENA region is scarce. Further research and high-quality epidemiological studies are urgently needed to gain a deep understanding of the TBI burden in the region, facilitate the allocation of adequate resources, implement effective preventive and intervention strategies and advise on the TBI patient management as reflective on the TBI patterns and modes.

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The burden of Respiratory Syncytial Virus (RSV) infection in the Middle East and North Africa (MENA) region across age groups: A systematic review

Vaccine ◽

10.1016/j.vaccine.2021.05.076 ◽

2021 ◽

Author(s):

Yolla Youssef ◽

Ahmad Chmaisse ◽

Celina Boutros ◽

Sarah Chamseddine ◽

Danielle Fayad ◽

...

Keyword(s):

Systematic Review ◽

Respiratory Syncytial Virus ◽

Middle East ◽

North Africa ◽

Age Groups ◽

Mena Region ◽

Rsv Infection ◽

Syncytial Virus

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Prevalence of Latent Tuberculosis Infection in the Middle East and North Africa: A Systematic Review

Pulmonary Medicine ◽

10.1155/2021/6680651 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Mazin Barry

Keyword(s):

Systematic Review ◽

Middle East ◽

North Africa ◽

Subgroup Analysis ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

World Health ◽

Published Data ◽

Mena Region

Objective. Data on the prevalence of latent tuberculosis infection (LTBI) in Middle Eastern and North African countries are scarce. We aimed to review all relevant published data in countries belonging to this region to determine the overall prevalence of LTBI in the Middle East and North Africa (MENA) region. Methods. In this systematic review PubMed and Google Scholar databases were searched for observational, prospective, retrospective, cross-sectional, and cohort studies providing prevalence data of LTBI in any MENA country. Studies fulfilling the search criteria were incorporated in the review. Overall prevalence of LTBI with 95% confidence intervals (CI) was calculated using the random-effects model; heterogeneity was assessed using I 2 statistics. Gender and age group-based subgroup analyses were performed to evaluate the basis of heterogeneity. Results. The total number of overall LTBI studies identified was 956, of which 31 studies from ten countries within the MENA region were included that represented 12,439 subjects. The overall prevalence was 41.78% (95% CI 31.18% to 52.78%, I 2 = 99.31 % ). By gender-based subgroup analysis, the prevalence of LTBI was 33.12% (95% CI 18.97% to 49.04%, I 2 = 99.25 % ) and 32.65% (95% CI 19.79% to 47%, I 2 = 98.89 % ) in males and females, respectively, while in the age-based subgroup analysis, the prevalence of LTBI was 0.44% (95% CI -0.05% to 0.9%), 3.37% (95% CI 2.23% to 4.74%, I 2 = 0 % ), and 43.81% (95% CI 33.09% to 54.82%, I 2 = 99.18 % ) for children, adolescents, and adults, respectively. Conclusion. This systematic review reveals a high prevalence of LTBI in the MENA region; enhanced LTBI surveillance and prompt infection prevention steps are urgently needed to prevent active tuberculosis, this would help achieve the World Health Organization End TB Strategy 2035, and the United Nations Sustainable Development Goals 2030 target in the MENA region.

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The epidemiology of Norovirus in the Middle East and North Africa (MENA) region: a systematic review

Virology Journal ◽

10.1186/s12985-017-0877-3 ◽

2017 ◽

Vol 14 (1) ◽

Cited By ~ 13

Author(s):

Khalil Kreidieh ◽

Rana Charide ◽

Ghassan Dbaibo ◽

Nada M. Melhem

Keyword(s):

Systematic Review ◽

Middle East ◽

North Africa ◽

Mena Region

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A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Health impact and management

Advances in Pediatric Research ◽

10.12715/apr.2017.4.6 ◽

2017 ◽

Cited By ~ 1

Keyword(s):

Systematic Review ◽

Childhood Obesity ◽

Middle East ◽

North Africa ◽

Health Impact ◽

Mena Region

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Systematic Review of the Respiratory Syncytial Virus (RSV) Prevalence, Genotype Distribution, and Seasonality in Children from the Middle East and North Africa (MENA) Region

Microorganisms ◽

10.3390/microorganisms8050713 ◽

2020 ◽

Vol 8 (5) ◽

pp. 713 ◽

Cited By ~ 1

Author(s):

Hadi M. Yassine ◽

Muhammad U. Sohail ◽

Nadin Younes ◽

Gheyath K. Nasrallah

Keyword(s):

Systematic Review ◽

Respiratory Syncytial Virus ◽

Middle East ◽

North Africa ◽

Respiratory Infections ◽

Age Distribution ◽

Genotype Distribution ◽

Mena Region ◽

Vaccine Introduction ◽

Syncytial Virus

Respiratory syncytial virus (RSV) is one of the most common viruses to infect children worldwide and is the leading cause of lower respiratory tract illness (LRI) in infants. This study aimed to conduct a systematic review by collecting and reviewing all the published knowledge about the epidemiology of RSV in the Middle East and North Africa (MENA) region. Therefore, we systematically searched four databases; Embase, Medline, Scopus, and Cochrane databases from 2001 to 2019 to collect all the information related to the RSV prevalence, genotype distribution, and seasonality in children in MENA region. Our search strategy identified 598 studies, of which 83 met our inclusion criteria, which cover the past 19 years (2000–2019). Odds ratio (OR) and confidence interval (CI) were calculated to measure the association between RSV prevalence, gender, and age distribution. An overall prevalence of 24.4% (n = 17,106/69,981) of respiratory infections was recorded for RSV. The highest RSV prevalence was reported in Jordan (64%, during 2006–2007) and Israel (56%, 2005–2006). RSV A subgroup was more prevalent (62.9%; OR = 2.9, 95%CI = 2.64–3.13) than RSV B. RSV was most prevalent in children who were less than 12 months old (68.6%; OR = 4.7, 95%CI = 2.6–8.6) and was higher in males (59.6%; OR = 2.17, 95%CI = 1.2–3.8) than in female infants. Finally, the highest prevalence was recorded during winter seasons in all countries, except for Pakistan. RSV prevalence in the MENA region is comparable with the global one (24.4% vs. 22%). This first comprehensive report about RSV prevalence in the MENA region and our data should be important to guide vaccine introduction decisions and future evaluation.

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LO93: Prognostic value of S-100B protein for prediction of post-concussion symptoms following a mild traumatic brain injury: systematic review and meta-analysis

CJEM ◽

10.1017/cem.2017.155 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S60

Author(s):

E. Mercier ◽

P. Tardif ◽

P. Cameron ◽

B. Batomen Kuimi ◽

M. Émond ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Serum Level ◽

Mild Traumatic Brain Injury ◽

Prognostic Value ◽

Search Strategy ◽

Meta Analysis ◽

Risk Of Bias ◽

Protein Serum

Introduction: Mild traumatic brain injury (mTBI) is a major cause of morbidity but there are no validated tools to help clinicians predict post-concussion symptoms. This systematic review and meta-analysis aimed to determine the prognostic value of S-100B protein to predict post-concussion symptoms following a mTBI in adults. Methods: The protocol of this systematic review was registered with the PROSPERO database (CRD42016032578). A search strategy was performed on seven databases (CINAHL, Cochrane CENTRAL, EMBASE, MEDLINE, Web of Knowledge, PyscBITE, PsycINFO) from their inception to October 2016. Studies evaluating the association between S-100B protein level and post-concussion symptoms assessed at least seven days after the mTBI were eligible. Individual patient data were requested. Studies eligibility assessment, data extraction and risk of bias assessment were performed independently by two researchers. Analyses were done following the meta-analysis using individual participant data or summary aggregate data guidelines from the Cochrane Methodology Review Group. Results: Outcomes were dichotomised as persistent (≥3 months) or early (≥7 days <3 months). Our search strategy yielded 23,298 citations of which 29 studies presenting between seven and 223 patients (n=2505) were included. Post-concussion syndrome (PCS) (16 studies), neuropsychological symptoms (9 studies) and health-related quality of life (4 studies) were the most frequently presented outcomes. The S-100B protein serum level of patients with no PCS was similar to that of patients experiencing persistent PCS (mean difference 0.00 [-0.05, 0.04]) or early PCS (mean difference 0.03 [-0.02, 0.08]). The odds of having persistent PCS (OR 0.56 (95% CI: 0.29-1.10) or early PCS (OR 1.67 (95% CI: 0.98-2.85) in patients with an elevated S-100B protein serum level was not significantly different from that of patients with normal values. No meta-analysis was performed for other outcomes than PCS due to heterogeneity and small samples. Studies’ overall risk of bias was considered moderate. Conclusion: Results suggest that the prognostic value of S-100B protein serum level to predict persistent and early post-concussion symptoms is limited. Variability in injury to S-100B protein sample time and outcomes assessed could potentially explain the lack of association and needs further evaluation.

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Prevalence of Traumatic Brain Injury Among Trauma Patients in Ethiopia: Systematic Review and Meta-Analysis

Annals of African Surgery ◽

10.4314/aas.v18i1.3 ◽

2021 ◽

Vol 18 (1) ◽

pp. 10-17

Author(s):

Semagn Mekonnen Abate ◽

Bedru Jemal Abafita ◽

Tesfanew Bekele

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Road Traffic Accident ◽

Traffic Accident ◽

Road Traffic ◽

Meta Analysis ◽

Grey Literature ◽

Trauma Patients ◽

Medical Care System

Background: Traumatic brain injury (TBI) is a common cause of mortality and disability in young age populations, particularly in children and adolescents. The objective of this systematic review and metaanalysis was to assess the prevalence of TBI among trauma patients in Ethiopia. Methods: A three-stage search strategy was conducted on PubMed/Medline, Science Direct and African Journals Online, and a grey literature search was conducted on Google Scholar. Data were analyzed with R version 3.6.1. Results: The pooled prevalence of TBI in Ethiopia was 20% (95% confidence interval (CI), 11–32). Subgroup analysis revealed that road traffic accident was the commonest mechanism of injury in Ethiopia at 21% (95% IC, 15– 30), next was assault at 18% (95% CI, 5–48). Conclusion: This review shows a high prevalence of TBI among trauma patients in Ethiopia when compared with continental and global reports. Policymakers and stakeholders should work on regulatory laws on transportation; pre-hospital emergency medical care system is also in high demand.Keywords: Head injury, Road traffic accident, Assault, Ethiopia

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A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis

Advances in Pediatric Research ◽

10.12715/apr.2017.4.8 ◽

2017 ◽

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Childhood Obesity ◽

Middle East ◽

North Africa ◽

Meta Analysis ◽

Mena Region

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Barriers and Facilitators Associated with Physical Activity in the Middle East and North Africa Region: A Systematic Overview

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041647 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1647 ◽

Cited By ~ 1

Author(s):

Sonia Chaabane ◽

Karima Chaabna ◽

Sathyanarayanan Doraiswamy ◽

Ravinder Mamtani ◽

Sohaila Cheema

Keyword(s):

Physical Activity ◽

Middle East ◽

Systematic Reviews ◽

North Africa ◽

Physical Inactivity ◽

Dietary Habits ◽

Barriers And Facilitators ◽

Health Concern ◽

Mena Region ◽

Mena Countries

Increasing physical inactivity levels in the Middle East and North Africa (MENA) region is a public health concern. We aimed to synthesize barriers and facilitators to physical activity and make appropriate recommendations to address physical inactivity. We conducted an overview of systematic reviews on physical activity barriers and facilitators in 20 MENA countries by systematically searching MEDLINE/PubMed and Google Scholar for systematic reviews published between 2008 and 2020. Our overview included four systematic reviews and 119 primary studies with data from 17 MENA countries. Lack of suitable sports facilities, time, social support and motivation, gender and cultural norms, harsh weather, and hot climate were the most commonly reported barriers to physical activity. Socio-demographic factors negatively associated with physical activity participation include advanced age, being female, less educated, and being married. Motivation to gain health benefits, losing/maintaining weight, being male, dietary habits, recreation, and increased Body Mass Index are positively associated with increased levels of physical activity. Interventions promoting physical activity in MENA should target schoolchildren, women and girls, working parents, and the elderly. Country-specific sociocultural and environmental factors influencing physical activity should be considered in the design of interventions. Current and future policies and national interventions must be consistently evaluated for effectiveness and desired outcomes.

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