Strategies to increase immunization coverage of tetanus vaccine among women in Sub Saharan Africa: a systematic review

Abstract Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.

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Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review

10.21203/rs.3.rs-17855/v3 ◽

2020 ◽

Author(s):

Joseph Benjamin Bangura ◽

Shui-yuan Xiao ◽

Dan Qiu ◽

Feiyun Ouyang ◽

Lei Chen

Keyword(s):

Systematic Review ◽

Health Systems ◽

Immunization Coverage ◽

Case Control ◽

Sub Saharan Africa ◽

Immunization Programs ◽

Childhood Immunization ◽

Cross Sectional ◽

National Immunization ◽

Sub Saharan

Abstract Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.

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Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review

10.21203/rs.3.rs-17855/v2 ◽

2020 ◽

Author(s):

Joseph Benjamin Bangura ◽

Shui-yuan Xiao ◽

Dan Qiu ◽

Feiyun Ouyang ◽

Lei Chen

Keyword(s):

Systematic Review ◽

Health Systems ◽

Immunization Coverage ◽

Case Control ◽

Sub Saharan Africa ◽

Immunization Programs ◽

Childhood Immunization ◽

Cross Sectional ◽

National Immunization ◽

Sub Saharan

Abstract Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.

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Khat chewing and risky sexual behavior in Sub-Saharan Africa: a systematic review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2013-877 ◽

2013 ◽

Vol 11 (12) ◽

pp. 59-67 ◽

Cited By ~ 4

Author(s):

Amanuel Tesfay Gebremedhin ◽

Hailay Abrha Gesesew ◽

Tariku Dejene Demissie ◽

Mirkuzie Woldie Kerie ◽

Morankar Sudhakar

Keyword(s):

Systematic Review ◽

Sexual Behavior ◽

Risky Sexual Behavior ◽

Sub Saharan Africa ◽

Systematic Review Protocol ◽

Khat Chewing ◽

Review Protocol ◽

Sub Saharan

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Gambling Patterns and Problem Gambling Among Youth in Sub-Saharan Africa: A Systematic Review

Journal of Gambling Studies ◽

10.1007/s10899-021-10001-w ◽

2021 ◽

Author(s):

Byron K. Y. Bitanihirwe ◽

Derrick Ssewanyana

Keyword(s):

Systematic Review ◽

Problem Gambling ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Gambling Patterns

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Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00822-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hafte Kahsay Kebede ◽

Lillian Mwanri ◽

Paul Ward ◽

Hailay Abrha Gesesew

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Hiv Care ◽

Care Services ◽

Validity Assessment ◽

Sub Saharan ◽

Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

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Behavioural interventions promoting condom use among female sex workers in sub-Saharan Africa: a systematic review

African Journal of AIDS Research ◽

10.2989/16085906.2017.1358753 ◽

2017 ◽

Vol 16 (3) ◽

pp. 257-268 ◽

Cited By ~ 7

Author(s):

Uchenna O Okafor ◽

Rik Crutzen ◽

Yauri Aduak ◽

Sylvia Adebajo ◽

Hubertus W Van den Borne

Keyword(s):

Systematic Review ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Sub Saharan Africa ◽

Behavioural Interventions ◽

Female Sex ◽

Sub Saharan

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Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052477 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2477

Author(s):

Panmial Priscilla Damulak ◽

Suriani Ismail ◽

Rosliza Abdul Manaf ◽

Salmiah Mohd Said ◽

Oche Agbaji

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Behavioral Interventions ◽

Controlled Trial ◽

Self Report ◽

Sub Saharan Africa ◽

Art Adherence ◽

Study Characteristics ◽

Combination Study ◽

Sub Saharan

Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.

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