Prevalence, incidence and risk factors for anogenital warts in Sub Saharan Africa: a systematic review and meta analysis

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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Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

Trauma Violence & Abuse ◽

10.1177/1524838020906560 ◽

2020 ◽

pp. 152483802090656 ◽

Cited By ~ 2

Author(s):

Eric Y. Tenkorang ◽

Michael Asamoah-Boaheng ◽

Adobea Y. Owusu

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Intimate Partner Violence ◽

Partner Violence ◽

Meta Analysis ◽

Intimate Partner ◽

Sub Saharan Africa ◽

Hiv Positive ◽

Hiv Positive Women ◽

Sub Saharan

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.

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The association between antiretroviral therapy and selected cardiovascular disease risk factors in sub-Saharan Africa: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0201404 ◽

2018 ◽

Vol 13 (7) ◽

pp. e0201404 ◽

Cited By ~ 5

Author(s):

Christian Akem Dimala ◽

Hannah Blencowe ◽

Simeon Pierre Choukem

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Disease ◽

Antiretroviral Therapy ◽

Disease Risk ◽

Meta Analysis ◽

Cardiovascular Disease Risk ◽

Sub Saharan Africa ◽

Cardiovascular Disease Risk Factors ◽

Sub Saharan

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Neonatal Septicaemia in Sub-Saharan Africa: A Protocol for Systematic Review and Meta-analysis.

10.21203/rs.3.rs-112780/v1 ◽

2020 ◽

Author(s):

Micheal Abel Alao ◽

Oluwakemi O Tongo ◽

Idowu Adejumoke Ayede ◽

Michael Udochukwu Diala ◽

Olayinka Rasheed Ibrahim ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Hospital Mortality ◽

Observational Studies ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Sub Saharan Africa ◽

Bacterial Isolates ◽

Neonatal Septicaemia ◽

Sub Saharan

Abstract Background: The morbidity and mortality from neonatal septicaemia (NNS) in low-middle income country remain high at the background of strained health care delivery system.The burden, pooled risks and outcomes of NNS are largely unknown. We aimed to produce a protocol for synthesizing evidence from available data for neonatal septicaemia in sub-Saharan Africa.Methods: We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only Observational studies retrievable in the English Language will be included. The primary measurable outcome is the proportion of neonatal with septicaemia while secondary outcomes include proportion of bacterial isolates and their antibiogram, risk factors for NNS, in hospital mortality, length of hospital stay, frequency of necrotizing enterocolitis and other sequel . All identified studies will be screened based on the inclusion criteria. Data will be deduplicated in Endnote version 9, before exporting to Rayyan QCRI for screening. Extractable data will include first author’s name and year of publication, the country and regions in sub-Saharan Africa, total neonatal admissions, number with sepsis, the sample size, bacterial isolates, antibiogram, in-hospital mortality, length of hospital stay and frequency of necrotizing enterocolitis.All studies will be assessed for methodological, clinical and statistical heterogeneity. The NIH Quality assessment tool for observational studies and the Cochrane tool of risk of bias will be used to assess for the strength of evidence. Publication bias will be assessed using the funnel plot.Discussion: Results will be presented as the prevalence, standard error and confidence interval of newborns with neonatal septicaemia in sub-Saharan Africa. Subgroup analysis using categorical data such as risk factors, bacterial isolates, antibiogram and outcomes of neonatal septicaemia will also be reported. A cumulative meta-analysis will be done to assess the time trend of the risk factors, pathogens and antibiogram.The CMA version 3 will be used for statistical analysis. Results will be presented in forest plots.Systematic Review Registration: This protocol is registered in PROSPERO, registration number CRD42020219604.

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Association between highly active antiretroviral therapy and selected cardiovascular disease risk factors in sub-Saharan Africa: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2016-013353 ◽

2017 ◽

Vol 7 (3) ◽

pp. e013353 ◽

Cited By ~ 4

Author(s):

Christian Akem Dimala ◽

Hannah Blencowe

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Highly Active Antiretroviral Therapy ◽

Disease Risk ◽

Meta Analysis ◽

Cardiovascular Disease Risk ◽

Sub Saharan Africa ◽

Highly Active ◽

Sub Saharan ◽

Analysis Protocol

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Risk factors for 30-day in-hospital mortality for in-patient with stroke in sub-Saharan Africa: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-049927 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049927

Author(s):

Martin Ackah ◽

Cynthia Osei Yeboah ◽

Louise Ameyaw

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Analytical Models ◽

Stroke Mortality ◽

Eligibility Criteria ◽

Hospital Patients ◽

Sub Saharan ◽

Reported Data

IntroductionWhile individual studies have reported on in-hospital stroke mortality rates in sub-Saharan Africa (SSA), the estimates are highly variable and inconclusive, buttressing the need for precise and reliable estimations. To overcome these inconsistencies, a well-structured systematic review and meta-analytical models are necessary. However, to the best of our knowledge, there is no published systematic review and meta-analysis on risk factors for 30-day mortality for in-hospital patients with stroke in SSA.Method and analysisWe will include all retrospective and prospective facility-based observational studies reporting on the incidence and/or risk factors for in-hospital stroke mortality in SSA. Electronic databases such as PubMed, Google scholar and Africa Journal Online (AJOL) will be searched for potentially relevant studies on in-hospital stroke mortality and risk factors in SSA. The search will be limited to studies conducted from January 1990 to December 2020. Two independent authors will screen titles and abstract to find studies that meet the prespecified eligibility criteria for inclusion in the review. The incidence of 30-day in hospital stroke mortality will be pooled. Meta-regression will be used to assess the factors associated with in-hospital stroke mortality in SSA. If possible, subgroup analysis will be performed based on subregion, publication year and study design, and quality score to determine possible source of heterogeneity. If possible, a sensitivity analysis will be performed to determine the robustness of the estimates obtained from the meta-analysis.Ethics and disseminationEthical approval is not required as this is a secondary research and will use reported data in scientific literature. A full manuscript will be submitted to a reputable peer-review journal for publication.PROSPERO registration numberCRD42021227367.

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Association between food insecurity and key metabolic risk factors for diet-sensitive non-communicable diseases in sub-Saharan Africa: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-84344-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sphamandla Josias Nkambule ◽

Indres Moodley ◽

Desmond Kuupiel ◽

Tivani P. Mashamba-Thompson

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Food Insecurity ◽

Meta Analysis ◽

Metabolic Risk Factors ◽

Sub Saharan Africa ◽

Metabolic Risk ◽

Non Communicable Diseases ◽

Causal Pathway ◽

Sub Saharan

AbstractIn previous studies, food insecurity has been hypothesised to promote the prevalence of metabolic risk factors on the causal pathway to diet-sensitive non-communicable diseases (NCDs). This systematic review and meta-analysis aimed to determine the associations between food insecurity and key metabolic risk factors on the causal pathway to diet-sensitive NCDs and estimate the prevalence of key metabolic risk factors among the food-insecure patients in sub-Saharan Africa. This study was guided by the Centre for Reviews and Dissemination (CRD) guidelines for undertaking systematic reviews in healthcare. The following databases were searched for relevant literature: PubMed, EBSCOhost (CINAHL with full text, Health Source - Nursing, MedLine). Epidemiological studies published between January 2015 and June 2019, assessing the associations between food insecurity and metabolic risk outcomes in sub-Saharan African populations, were selected for inclusion. Meta-analysis was performed with DerSimonian-Laird’s random-effect model at 95% confidence intervals (CIs). The I2 statistics reported the degree of heterogeneity between studies. Publication bias was assessed by visual inspection of the funnel plots for asymmetry, and sensitivity analyses were performed to assess the meta-analysis results’ stability. The Mixed Methods Appraisal Tool (MMAT) – Version 2018 was used to appraise included studies critically. The initial searches yielded 11,803 articles, 22 cross-sectional studies were eligible for inclusion, presenting data from 26,609 (46.8% males) food-insecure participants, with 11,545 (42.1% males) reported prevalence of metabolic risk factors. Of the 22 included studies, we identified strong evidence of an adverse association between food insecurity and key metabolic risk factors for diet-sensitive NCDs, based on 20 studies. The meta-analysis showed a significantly high pooled prevalence estimate of key metabolic risk factors among food-insecure participants at 41.8% (95% CI: 33.2% to 50.8%, I2 = 99.5% p-value < 0.00) derived from 14 studies. The most prevalent type of metabolic risk factors was dyslipidaemia 27.6% (95% CI: 6.5% to 54.9%), hypertension 24.7% (95% CI: 15.6% to 35.1%), and overweight 15.8% (95% CI: 10.6% to 21.7%). Notably, the prevalence estimates of these metabolic risk factors were considerably more frequent in females than males. In this systematic review and meta-analysis, exposure to food insecurity was adversely associated with a wide spectrum of key metabolic risk factors, such as obesity, dyslipidaemia, hypertension, underweight, and overweight. These findings highlight the need to address food insecurity as an integral part of diet-sensitive NCDs prevention programmes. Further, these findings should guide recommendations on the initiation of food insecurity status screening and treatment in clinical settings as a basic, cost-effective tool in the practice of preventive medicine in sub-Saharan Africa.PROSPERO registration number: PROSPERO 2019 CRD42019136638.

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Estimating the burden of hypertension and its significant risk factors among male commercial drivers in sub-Saharan Africa: A systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-053825 ◽

2021 ◽

Vol 11 (12) ◽

pp. e053825

Author(s):

Martin Ackah ◽

Louise Ameyaw ◽

Mohammed Gazali Salifu ◽

Cynthia Osei Yeboah

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Alcohol Consumption ◽

Data Extraction ◽

Meta Analysis ◽

Significant Risk ◽

Sub Saharan Africa ◽

Male Adult ◽

Commercial Drivers ◽

Sub Saharan

ObjectiveThe study was designed to assess the burden and significant risk factors among male commercial drivers in sub-Saharan Africa (SSA).DesignSystematic review and meta-analysis.Data sourcesMedline via PubMed, Google Scholar, Cochrane databases and Africa Journal Online were searched from January 2010 to December 2020.Eligibility criteria for selecting studiesThe authors included observational studies reporting on the burden and/or risk factors for hypertension among commercial drivers in SSA. Male adult population ≥18 years working as a commercial driver in SSA as well articles published in English.Data extraction and synthesisTwo independent coauthors used a prepared data extraction form to extract data from the eligible published papers and assessed the risk of bias. DerSimonian and Laird random effects model was used to pool the burden of hypertension and significant risk factors among male commercial drivers in SSA. The presence of heterogeneity among studies was quantified by estimating variance using both Cochrane’s Q statistics and the I2 statistics. A subgroup and sensitivity analyses were performed.ResultsOverall, 14 articles met the inclusion criteria involving a total of 4285 male commercial drivers in SSA. The estimated pooled burden of hypertension among the male commercial drivers in SSA was 32% (95% CI 24% to 39%). The risk factors identified were age OR=1.10 (95% CI 1.06 to 1.15), overweight/obese OR=3.38 (95% CI 2.46 to 4.29), alcohol consumption OR=3.00 (95% CI 2.05 to 3.95) and duration of driving (≥5 years) OR=1.83 (95% CI 1.03 to 2.63). Funnel plot inspection and Egger’s regression test of small effect (0.5838) showed no evidence of publication bias.ConclusionsOur review showed that nearly one-third of male commercial drivers in SSA have hypertension. Reduction of modifiable risk factors such as overweight/obesity, alcohol consumption and long-term driving through multifaceted implementation strategies are recommended for prevention and control of hypertension among male commercial drivers in SSA.Trial registration numberCRD42021250910.

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Dominant and Modifiable Risk Factors for Dementia in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.627761 ◽

2021 ◽

Vol 12 ◽

Author(s):

Akin Ojagbemi ◽

Akinkunmi Paul Okekunle ◽

Opeyemi Babatunde

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Risk Factor ◽

Educational Attainment ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Modifiable Risk Factors ◽

Incident Dementia ◽

Sub Saharan ◽

The Life Course

Background: Sub-Saharan Africa (SSA) is projected to have a rapid increase in the number of people living with dementia by 2050. Yet, there is currently no robust evidence on the risk factors for dementia in the sub-region that could inform context specific interventions.Methods: We conducted a systematic review and meta-analysis of observational studies to determine the dominant and modifiable risk factors for dementia in SSA. We searched MEDLINE, EMBASE, PsychINFO, and African Journals Online using keywords for dementia and Alzheimer's disease as well as the.mp operator for all 47 SSA countries or regions. We included peer-reviewed original studies with epidemiological designs, conducted random effect meta-analysis and determined the dominant and modifiable risk factors for dementia using the inverse of variance method.Results: A total of 44 studies out of 2,848 met criteria for syntheses. The pooled annual incidence of dementia from 5,200 cohort risk years was 2.0% [(95% Confidence Interval (CI) = 1.0–4.0%)]. The pooled prevalence was 5.0% (95% CI = 2.0–7.0%). Older age was the dominant risk factor for both prevalent [(Standard error (S.E = 0.3, weight = 25.2%)] and incident dementia (S.E = 0.02, weight = 95.8%), while low educational attainment (S.E = 0.19, weight = 32.6%) and poor predementia cognitive functioning at baseline (S.E = 0.2, weight = 20.5%) were the best ranked modifiable risk factor for incident dementia.Conclusion: Low formal educational attainment which, in SSA, may represent a stable index of low socioeconomic position and health disadvantage over the life course, was the most prominent modifiable risk factor for incident dementia. Findings have implications for deliberate policies targeted at access to education across the life course as a primary prevention strategy against dementia in SSA.

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