scholarly journals Effect of Preterm Birth on the Risk of Adverse Perinatal and Neonatal Outcomes in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 58 ◽  
pp. 004695802110641
Author(s):  
Melaku Desta ◽  
Melaku Admas ◽  
Yordanos Yeshitila ◽  
Belsity Meselu ◽  
Keralem Bishaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Neonatal Mortality ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Group Analysis ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Care Providers ◽  
Increased Risk

Despite remarkable progress in the reduction of under-five mortality, the rate of perinatal and neonatal mortality is still high especially in developing countries. The adverse outcome associated with preterm birth is one of the major public health challenges in Africa. However, there are limited and inconsistent studies conducted on the effect of preterm birth on adverse perinatal and neonatal outcomes in Ethiopia. Therefore, this systematic review and meta-analysis aimed to investigate the association between preterm birth and its adverse perinatal and neonatal outcomes in Ethiopia. We systematically searched several electronic databases like PubMed, Web of Science, SCOPUS, CINAHL, Google Scholar, African Journals Online databases and Science Direct. All identified observational studies were included. The I 1 statistics were used to assess the heterogeneity among the studies. A random-effects model was computed to estimate the pooled effect of preterm birth on adverse perinatal and neonatal outcomes. Thirty-three studies with a total of 20 109 live births were included in the final meta-analysis. Our meta-analysis showed that preterm birth increased the odds of perinatal mortality by 10-folds [POR = 9.56 (95% CI: 5.47, 19.69)] and there was a 5.44-folds risk of stillbirth [Odds Ratio = 5.44 (95% CI: 3.57, 8.28)] among women who gave birth before 37 weeks of gestation. In addition, preterm birth was significantly associated with neonatal hypothermia [OR=3.54 (95% CI: 2.41, 5.21)], neonatal mortality [OR= 3.16 (95% CI: 1.57, 6.34). The sub-group analysis of this meta-analysis showed that there was an increased risk of neonatal sepsis [OR=2.33 (95% CI: 1.15, 4.71)] among preterm babies. Preterm births significantly increased the risk of adverse perinatal and neonatal outcomes in Ethiopia. Therefore, scale-up strategies and improving the quality of maternal and child health care providers should be an area of intervention to reduce adverse outcomes associated with preterm birth. The Federal Ministry of Health and concerned bodies should work towards the prevention of preterm birth and its adverse outcomes.

Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta analysis of the literature

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 6082-6082 ◽  
Author(s):  
G. Dranitsaris ◽  
M. Johnston ◽  
S. Poirier ◽  
T. Trudi Schueller ◽  
T. Savage ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Cancer Drugs ◽  
Increased Risk

Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta-analysis of the literature

2005 ◽  
Vol 11 (2) ◽  
pp. 69-78 ◽  
Author(s):  
George Dranitsaris ◽  
Mary Johnston ◽  
Susan Poirier ◽  
Trudi Schueller ◽  
Debbie Milliken ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Cancer Drugs ◽  
Increased Risk

scholarly journals Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Heidi F. A. Moossdorff-Steinhauser ◽  
Bary C. M. Berghmans ◽  
Marc E. A. Spaanderman ◽  
Esther M. J. Bols
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Case Definitions ◽  
Monthly Basis ◽  
Policy Makers ◽  
In Pregnancy

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.

scholarly journals Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

2020 ◽  
Author(s):  
ling wang ◽  
Feng Jin
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Meta Analysis ◽  
Controlled Study ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Increased Risk ◽  
Study Heterogeneity

Abstract Background : To assess the association of sleep duration and quality with the risk of preterm birth. Methods : Relevant studies were retrieved from the PubMed and Web of Science databases up to September 30, 2018. The reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). Results : Ten identified studies (nine cohort studies and one case-controlled study) examined the associations of sleep duration and quality with the risk of preterm birth. As compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01–1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity ( I 2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity ( I 2 = 76.7%). Funnel plots as well as the Egger’s and Begg’s tests revealed no evidence of publication bias. Conclusions : This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth. Further subgroup analyses are warranted to test the robustness of these findings as well as to identify potential sources of heterogeneity.

scholarly journals Cerebral microbleeds and risk of adverse outcomes in patients with atrial fibrillation: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B Corica ◽  
G.F Romiti ◽  
V Raparelli ◽  
R Cangemi ◽  
S Basili ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Adverse Outcomes ◽  
Cerebral Microbleeds ◽  
Funding Sources ◽  
Conflicting Evidence ◽  
Pooled Prevalence ◽  
Increased Risk

Abstract Background Long-term anticoagulation in patients with atrial fibrillation (AF) imposes a careful balance between the thromboembolic and hemorrhagic risks. An association between cerebral microbleeds (CMBs) and an increased risk of intracranial hemorrhage (ICH) has already been described; however, conflicting evidence exist on the association with ischemic stroke (IS). Although CMBs are often observed in AF patients, the actual prevalence and the magnitude of the risk of adverse events in patients with CMBs is unclear. Purpose We aimed to estimate the pooled prevalence of CMBs in patients with AF through a systematic review and meta-analysis of the literature. Additionally, we evaluated the risk of ICH and IS according to the presence and burden of CMBs. Methods We perform a systematic search on PubMed and EMBASE from inception to 6th March 2021. We included all studies reporting the prevalence of CMBs, the incidence of ICH and/or IS in AF by presence of CMBs. Pooled prevalence and odds ratios (OR), along with their 95% Confidence Intervals (CI), were computed using random-effect models; we also calculated 95% Prediction Intervals (PI) for each outcome investigated. Additionally, we performed subgroup analyses according to the number and localization of CMBs. Results We retrieved 562 records from the literature search, and 17 studies were finally included. Pooled prevalence of CMBs in AF population was 28.3% (95% CI: 23.8%-33.4%; 95% PI: 12.2%-52.9%, Figure 1). Individuals with CMBs showed a higher risk of both ICH (OR: 3.04, 95% CI: 1.83–5.06) and IS (OR: 1.78, 95% CI: 1.26–2.49). Moreover, patients with more than 5 CMBs, as well as patients with both lobar and mixed CMBs, showed a higher risk of ICH. Conclusions CMBs were found in 28.3% of AF patients, with 95% PIs indicating a potentially higher prevalence. Moreover, CMBs were associated with an increased risk of both ICH and IS, with the effect potentially modulated by their number and localization. CMBs may represent an important and often overlooked risk factor for adverse outcomes in patients with AF. FUNDunding Acknowledgement Type of funding sources: None. Prevalence of CMBs in patients with AF

scholarly journals Recovery rate and determinants of severe acute malnutrition children treatment in Ethiopia: a systematic review and meta-analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Kassahun Gebeyehu Yazew ◽  
Chanyalew Worku Kassahun ◽  
Amare Wondim Ewnetie ◽  
Habtamu Kerebih Mekonen ◽  
Endalamaw Salilew Abagez
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Congestive Heart Failure ◽  
Health Care Providers ◽  
Recovery Rate ◽  
Severe Acute Malnutrition ◽  
Meta Analysis ◽  
Acute Malnutrition ◽  
Cochrane Library ◽  
Care Providers

Abstract Background Severe acute malnutrition affects more than 20 million children. Africa is pointed out as a region where the problem is highly prevalent. There were individual studies on the recovery rate and its determinants among children with severe acute malnutrition in Ethiopia. But, there is no national pooled estimate. Therefore, this systematic review and meta-analysis aimed to estimate the recovery rate and determinants among children with severe acute malnutrition admitted to the therapeutic feeding unit in Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed in this study. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google Scholar, and EMBASE. The statistical analysis was conducted using STATA version-11 software. The pooled prevalence was estimated with 95% confidence intervals using a random-effects model. Result A total of 12 studies were included with 2658 participants in the analysis. The overall pooled estimated recovery rate among children with severe acute malnutrition admitted to the inpatient therapeutic feeding unit in Ethiopia was 72.02 % (CI, 64.83, 79.22%). In the subgroup analysis, the highest estimate (80.29%) was observed in studies conducted in Oromia regional state, while 68.63% was observed in studies Southern Nation Nationality of people region 68.63%. Children who had no congestive heart failure were 4.88 times (OR, 4.88; 95% CI, 2.246, 10.586) more likely to recover than their counterparts. Conclusion The recovery rate among severe acute malnourished children on the therapeutic feeding unit in Ethiopia lied within the international minimum sphere. Hence, health care providers shall strengthen the management of severe acute malnutrition and management other co-morbidities like congestive heart failure. Systematic review registration PROSPERO CRD42019119124

scholarly journals Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohammad Karimian ◽  
Hassan Nourmohammadi ◽  
Majid Salamati ◽  
Mohammad Reza Hafezi Ahmadi ◽  
Fatemeh Kazemi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Health Care Providers ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Iranian Population ◽  
Cochrane Library ◽  
Care Providers ◽  
Online Databases

Abstract Background Gastroesophageal reflux disease (GERD), which leads to acid reflux into the esophagus, is a common gastrointestinal disorder. Several studies have shown the prevalence of GERD in Iranian population, but their evidence is contradictory. Therefore, the present study was conducted to investigate the epidemiology of GERD in Iran. Methods The entire steps of this systematic review and meta-analysis were based on the MOOSE protocol, and the results were reported accordance with the PRISMA guideline. This review is registered on PROSPERO (registration number: CRD42020142861). To find potentially relevant published articles, comprehensive search was done on international online databases Scopus, Science Direct, EMBASE, PubMed/Medline, CINAHL, EBSCO, Cochrane Library, Web of Science, Iranian online databases and the Google Scholar search engine in June 2019. Cochran test and I2 index were used to assess the heterogeneity of the studies. Data were analyzed using Comprehensive Meta-Analysis software ver. 2. The significance level of the test was considered to be P <  0.05. Results The daily, weekly, monthly, and overall prevalence of GERD symptoms in Iranian population was 5.64% (95%CI [confidence interval]: 3.77–8.35%; N = 66,398), 12.50% (95%CI: 9.63–16.08%; N = 110,388), 18.62% (95%CI: 12.90–26.12%; N = 70,749) and 43.07% (95%CI: 35.00–51.53%; N = 73,189), respectively. The daily, weekly, monthly, and overall prevalence of heartburn in Iranian population was 2.46% (95%CI: 0.93–6.39%; N = 18,774), 9.52% (95%CI: 6.16–14.41%; N = 54,125), 8.19% (95%CI: 2.42–24.30%; N = 19,363) and 23.20% (95%CI: 13.56–36.79%; N = 26,543), respectively. The daily, weekly, monthly, and overall prevalence of regurgitation in Iranian population was 4.00% (95%CI: 1.88–8.32%; N = 18,774), 9.79% (95%CI: 5.99–15.60%; N = 41,140), 13.76% (95%CI: 6.18–44.31%; N = 19,363) and 36.53% (95%CI: 19.30–58.08%; N = 21,174), respectively. The sensitivity analysis for prevalence of all types GERD, heartburn and regurgitation symptoms by removing a study showed that the overall estimate is still robust. Conclusion The present meta-analysis provides comprehensive and useful information on the epidemiology of GERD in Iran for policy-makers and health care providers. This study showed a high prevalence of GERD in Iran. Therefore, effective measures on GERD-related factors such as lifestyle can be among the health policies of Iran.

Systematic review of interventions to facilitate advance care planning (ACP) in cancer patients.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 21-21 ◽  
Author(s):  
Bryan Chan ◽  
Hao-Wen Sim ◽  
Camilla Zimmermann ◽  
Monika K. Krzyzanowska
Keyword(s):  
Systematic Review ◽  
Health Care Providers ◽  
Study Design ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Small Sample ◽  
Study Quality ◽  
Care Providers ◽  
Documentation System ◽  
Code Status

21 Background: ACP refers to the process of consideration, documentation and communication of preferences for future care. ACP is crucial for patients (pts) with advanced cancer as it can guide substitute decision makers (SDM) and health care providers (HCP) to align care with preferences, thus improving quality of end-of-life care. Methods: We performed a systematic review of MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane (Systematic Review and Clinical Trial) databases (1995 to 2015) to identify interventions that facilitate ACP for cancer pts (documentation or discussion of advance directives, SDM or code status). We extracted data on study design, setting, subject numbers, interventions and outcomes. Study quality was assessed using a modified Downs and Black checklist. Results: Of the 64,196 unique citations identified, 10 studies met inclusion criteria for testing interventions using a pre-post or controlled trial design (median sample size 134, range 48-9105). Interventions were categorized based on target audience: health system (n = 4), pts and caregivers (n = 3) or HCP (n = 3). Types of interventions included: introduction of ACP facilitators (n = 4), reminders or prompts (n = 2), and HCP training, videos, website or pt screening (n = 1 each). Heterogeneity in study design, outcome measures and small sample sizes limited study quality and precluded meta-analysis. Prompts such as medical record or email reminders were most consistently associated with improved ACP documentation. System changes incorporating the use of ACP facilitators also improved ACP documentation in 3 out of 4 studies. Interactive HCP training significantly improved confidence to initiate ACP discussions which has been identified as a barrier to timely ACP. Pilot trials showed no significant increase in ACP with educational videos/websites directed at pts. Passive HCP education and one-off reminders were also ineffective. Conclusions: The complexity of ACP is reflected in the multitude of interventions that have been evaluated but none are ready for wide-scale adoption. Further studies of interventions such as prompts and ACP facilitators are needed to inform the best approach to improve ACP uptake in cancer pts.

scholarly journals 17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdulaali R. Almutairi ◽  
Hadir I. Aljohani ◽  
Nouf S. Al-fadel
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Relative Risk Ratio ◽  
Analysis Model ◽  
Clinical Trial Registries

Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.Objective: To estimate the effect of 17-alpha-hydroxyprogesterone caproate (17-OHPC) compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.Work Design: Systematic review and meta-analysis.Search Strategy: Searching MEDLINE, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.Selection Criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular injection of 17-OHPC or placebo.Data Collection and Analysis: A random meta-analysis model was performed for the PTB outcomes (&lt;32, &lt;35, and &lt;37 weeks) and neonatal outcomes (neonatal death, grade 3 or 4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk ratio (RR) with a 95% confidence interval (CI).Main Results: Six works were included. There were no statistically significant reductions in the PTB risk following the use of 17-OHPC at &lt;32 weeks (RR = 0.61, 95% CI: 0.13–2.77, and I2 = 39%), &lt;35weeks (RR = 0.60, 95% CI: 0.10–3.67, and I2 = 51%), and &lt;37 weeks (RR = 0.68, 95% CI: 0.46–1, and I2 = 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups.Conclusion: Treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.

scholarly journals Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Woldu Aberhe ◽  
Abrha Hailay ◽  
Kidane Zereabruk ◽  
Guesh Mebrahtom ◽  
Teklehaimanot Haile
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Cochrane Review ◽  
World Health ◽  
Care Providers ◽  
Asthmatic Patients ◽  
Inconsistency Index ◽  
National Prevalence

Abstract Background Medication non-adherence is one of a common problem in asthma management and it is the main factor for uncontrolled asthma. It can result in poor asthma control, which leads to decreased quality of life, increase hospital admission, increased health care utilization, lost productivity, and mortality. To date, there have been no studies and protocols that estimated the pooled national prevalence of non-adherence to inhaled anti-asthmatic medications in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among asthmatic patients in Ethiopia. Methods Different database searching engines including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization afro library, and Cochrane review were systematically searched by using keywords such as “prevalence, non-adherence to inhaled medications, inhaled corticosteroids, and asthmatic patients” and their combinations. Six published observational studies that report the prevalence of non-adherence to inhaled medications were finally selected. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of non-adherence to inhale anti-asthmatic medications. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows. Results The pooled national prevalence of non-adherence to inhaled medications among asthmatic patients was 29.95% (95% CI, 19.1, 40.8%). The result of this meta-analysis using the random-effects model revealed that there is high heterogeneity across the included studies. The result of subgroup analysis indicates that one out of three in the Oromia region and one out of five in the Amhara region asthmatic patients was non-adherent to their inhaled anti-asthmatic medications. Conclusion the prevalence of non-adherence to inhaled anti-asthmatic medications was high. Thus, our finding suggests that one out of four asthmatic patients were non-adherent to inhaled medications. The ministry of health, health policymakers, clinicians, and other health care providers should pay attention to strengthening the adherence levels to inhaled anti-asthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to inhaled anti-asthmatic medications.

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