Systematic review and meta-analysis of iodine deficiency and its associated factors among pregnant women in Ethiopia

Abstract Background Iodine deficiency (ID) is a global public health problem and its impact is more pronounced in low-income countries. During pregnancy, iodine requirement is known to elevate sharply, making pregnant women, especially those living in low-income countries highly vulnerable to iodine deficiency. This study aims to assess the prevalence of iodine deficiency and its associated factors among pregnant women in Ethiopia. Methods A systematic literature search was performed by using PubMed, CINAHL, Web of science, global health, and Google scholar electronic databases. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence and pooled odds ratio. The presence of publication bias was checked using Funnel plot and Egger’s test. Results One thousand one hundred and sixteen studies were reviewed and seven studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of seven studies that included 2190 pregnant women showed a pooled prevalence of iodine deficiency during pregnancy to be 68.76% (95% CI: 55.21–82.31). In a subgroup analysis, the prevalence in Oromia region is 71.93% (95% CI: 54.87–88.99) and in Amhara region is 60.93% (95% CI: 57.39–64.48). Iodized salt use (AOR = 0.18; 95% CI: 0.08–0.44) and 1st trimester pregnancy (AOR = 0.68; 95% CI: 0.47–0.99) were found to have a significant association with iodine deficiency. Conclusions The prevalence of iodine deficiency during pregnancy using urine iodine is considerably high in Ethiopia. Using iodized salt is found to reduce the burden. Hence, there is a need to strengthen iodization programs to tackle the problem.

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Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2020/9418475 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Addisu Alehegn Alemu ◽

Liknaw Bewket Zeleke ◽

Bewket Yesarah Aynalem ◽

Getachew Mullu Kassa

Keyword(s):

Public Health ◽

Pregnant Women ◽

Associated Factors ◽

Meta Analysis ◽

Public Health Problem ◽

Hbv Infection ◽

Pooled Prevalence ◽

B Virus ◽

History Of ◽

Transfusion History

Background. Hepatitis B virus (HBV) is an infectious and a global public health problem. The prevalence of HBV infection among pregnant women is between 2.3% and 7.9%. HBV infection during pregnancy is associated with prenatal transmission to the fetus. HBV has an effective vaccine which reduces up to 96% of the transmission. Although different studies were conducted in Ethiopia, none of them showed the national prevalence of HBV infection among pregnant women. Therefore, this study was conducted to determine the pooled prevalence of HBV and its associated factors in Ethiopia. Methods. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles. All observational published studies were retrieved using relevant search terms in Google Scholar, African Online Journal, CINAHL, and PubMed databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 statistics were used to test heterogeneity whereas Begg’s and Egger’s tests were used to assess publication bias. Odds ratio (OR) with a 95% confidence interval (CI) was presented using the forest plot. Results. A total of twenty-three studies were included in this systematic review and meta-analysis. The pooled prevalence of HBV in Ethiopia was 4.75% (95% CI: 4.06, 5.44). The subgroup analysis showed a higher prevalence of HBV infection among pregnant women in Gambella (7.9%) and the lowest in Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (2.3%). Associated factors with HBV infection include history of multiple sexual partner (OR=6.02 (95%CI=3.86, 9.36)), blood transfusion history (OR=5.71 (95%CI=3.25, 10.04)), abortion history (OR=3.58 (95%CI=2.10, 6.09)), and history of body tattoo (OR=2.83 (95%CI=1.55, 5.17)). Conclusions. HBV infection among pregnant women is a common public health problem in Ethiopia. Multiple sexual partners, abortion history, blood transfusion history, and body tattoo were significantly associated with HBV infection. Policies and strategies should focus on factors identified in this study to improve the prevention of HBV among pregnant women.

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Breast self-examination practice and associated factors among female healthcare workers in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0241961 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241961

Author(s):

Birye Dessalegn Mekonnen

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Healthcare Workers ◽

Associated Factors ◽

Meta Analysis ◽

Public Health Problem ◽

Global Public Health ◽

Breast Self Examination ◽

Pooled Prevalence ◽

Self Examination

Background Breast cancer is common global public health problem. It is the principal cause of cancer related death. In Ethiopia, study findings regarding prevalence and associated factors of BSE among female healthcare workers have been inconsistently reported and highly variable. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of breast self-examination practice and determinants in Ethiopia. Methods A systematic search of PubMed, Medline, EMBASE, Global Health, Google Scholar, CINAHL and Scopus from April 2, 2020 to April 24, 2020. Data were extracted from articles included in the review using a data extraction tool which was adapted from the Joanna Briggs Institute. the quality of each included article was evaluated using the Newcastle-Ottawa scale. Data analysis was done using STATA 11. The Cochrane Q and I2 test were used to assess heterogeneity between the studies; and publication bias was assessed using funnel plots and Egger’s test. A random effects meta-analysis was computed to determine the pooled prevalence of breast self-examination. The determinants for breast self-examination were examined. Forest plots were used to present the prevalence and odds ratio with 95% confidence interval. Results After reviewing 9605 studies, 12 studies involving 4129 female healthcare workers were included for this review and meta-analysis. The pooled prevalence of breast self-examination practice among healthcare workers in Ethiopia was 56.31% (95% CI: 44.37, 68.25). The subgroup analysis further revealed that the higher breast self-examination practice was observed among other healthcare workers, 58.60% (95% CI: 43.31, 73.90). Good knowledge (AOR = 3.02; 95% CI: 1.24, 7.35), positive attitude (AOR = 2.73; 95% CI: 1.95, 4.13) and family history of breast cancer (AOR = 3.21; 95% CI: 1.22, 6.52) were significantly associated with breast self-examination practice among healthcare workers. Conclusion This meta-analysis found that nearly half of the female healthcare workers were not performed breast self-examination. The finding of this study suggests the need of strengthening early diagnosis of breast cancer and control strategies with a collaborative effort of policymakers and other concerned stakeholders.

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Iodine deficiency in women of childbearing age in Brazil: systematic review and meta-analysis

Revista Vitae ◽

10.17533/udea.vitae.v28n2a345572 ◽

2021 ◽

Vol 28 (2) ◽

Author(s):

Rosa Camila Lucchetta ◽

Ana Luísa Rodriguez Gini ◽

Sophia de Andrade Cavicchioli ◽

Marcela Forgerini ◽

Fabiana Rossi Varallo ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Sample Size ◽

Iodine Deficiency ◽

Associated Factors ◽

Meta Analysis ◽

Public Health Problem ◽

Small Sample ◽

Women Of Childbearing Age ◽

Childbearing Age

Background: Despite current policies of salt iodination, iodine deficiency is still a global public health problem, especially in women. So far, conflicting evidence has been suggested for the prevalence of iodine deficiency in Brazil. Objective: To estimate the prevalence of iodine deficiency and associated factors in women of childbearing age in Brazil. Methods: A systematic review was conducted using databases (PubMed, LILACS, WHO, Scopus, and Capes’ dissertation and thesis), from inception to May 2020. Meta-analyses of proportions were performed using the variance inverse for the fixed model. Reporting and methodological quality were assessed using the Joanna Briggs Institute tool to prevalence studies. Results: Our review identified seven studies published between 2002 e 2017, including 1354 participants, especially pregnant women. All studies presented at least one quality limitation, mainly regarding the sampling method (i.e., convenience) and small sample size. The prevalence of iodine deficiency ranged among studies from 16% to 62%. In contrast, the meta-analysis identified a mean prevalence of 40% (95% confidence interval, CI 37%-43%) for pregnant women and 13% (95% CI 4%-24%) for non-pregnant women. Cumulative meta-analysis suggests a tendency of higher iodine deficiency prevalence from 2018 in pregnant women. Conclusions: Although this systematic review identified studies with poor methodological and reporting quality, a high prevalence of iodine deficiency was identified in pregnant women, reinforcing the importance of national nutritional policies for monitoring iodine status in this population. Future studies should consider random probabilistic sampling, appropriate sample size, and pre-defined subgroup analysis to adequately inform the prevalence of iodine deficiency and associated factors in women of childbearing age and support health policies.

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Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03908-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zelalem Animaw ◽

Addisu Melese ◽

Habtamu Demelash ◽

Girma Seyoum ◽

Abiy Abebe

Keyword(s):

Pregnant Women ◽

Associated Factors ◽

Intestinal Parasites ◽

Meta Analysis ◽

Morbidity And Mortality ◽

Cochrane Library ◽

Stool Examination ◽

Parasitic Infections ◽

Intestinal Parasitic Infections ◽

Pooled Prevalence

Abstract Background Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. Methods Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. Results Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. Conclusions Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.

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Pooled Sputum for Xpert MTB/RIF Testing: A Cost Effectiveness Diagnostic Tool in Mwanza, Tanzania

10.21203/rs.3.rs-599005/v1 ◽

2021 ◽

Author(s):

Shimba Henerico ◽

Richard V. Makapa ◽

Bernard C. Okamo ◽

Benson R. Kidenya ◽

Geoffrey Japhet ◽

...

Keyword(s):

Cost Effectiveness ◽

Low Income ◽

Public Health Problem ◽

Positive Sample ◽

Low Income Countries ◽

Global Public Health ◽

Testing Strategy ◽

Pooled Testing ◽

The Individual ◽

Pooled Samples

Abstract Background: Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries, wherein the use of more sensitive diagnostics, such as Xpert MTB/RIF (GeneXpert), is still limited by costs. Testing of pooled samples from various individuals has been thought and thus investigated as a cost saving strategy to diagnose some diseases including TB. Then in cases where a pool is positive, retesting of the individual samples in that pool is done to identify the positive sample. We assessed the utility of a pooled testing strategy to optimize the affordability of GeneXpert for the diagnosis of TB Mwanza Tanzania. Methods: Remainder of samples from presumptive TB patients submitted for routine TB diagnosis were used for pooled samples (5 per pool) testing. The agreement of the results between individual sample testing against pooled samples testing and cost-effectiveness were assessed.Results: A total of 250 individual routinely submitted samples for TB diagnosis were tested using the established protocols. The median age of study participants was 35 [IQR 27 – 40] years and 143 (57.2%) were males. Of the 250 samples, 28 (11.2%) were detected to have MTB whereas 222 (88.8%) samples, were negative. Of the 50 sputum pools made, MTB were detected in 17 (34.0%) pools. Following retesting of these 17 positive pools, all 28 (100%) individual MTB samples were detected with the overall agreement being 100% (With the sensitivity of 100% and specificity of 100%). The number of individual MTB positive ranged from 1 to 3 per pool. Using pooling of sputum samples, the technique saved 115 (46.0%) of the cartridges in running 250 samples. This is equivalent to saving US$ 1147.7. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0%. The use of the pooled testing strategy reduces costs and has the potential to increase the affordability of GeneXpert testing in countries with limited resources. Pooled sputum for Xpert MTB/RIF can be used as an affordable diagnostic and/or screening tool in resource limited settings, such as Tanzania.

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Availability of Adequately Iodized Salt at Household Level and Associated Factors in Dire Dawa, Eastern Ethiopia

International Journal of Public Health Science (IJPHS) ◽

10.11591/.v5i4.4841 ◽

2016 ◽

Vol 5 (4) ◽

pp. 392

Author(s):

Anteneh Berhane Yaye ◽

Negga Baraki ◽

Birhanu Seyum Endale

Keyword(s):

Iodine Deficiency ◽

Associated Factors ◽

Public Health Problem ◽

Sampling Technique ◽

Iodized Salt ◽

School Age Children ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Household Level ◽

Dire Dawa

In Ethiopia, Iodine Deficiency Disorder has been recognized as a serious public health problem for the past six decades. In 2011, an estimated <br /> 12 million school-age children were living with inadequate iodine, and <br /> 66 million people were at risk of iodine deficiency. One out of every <br /> 1000 people is a cretin mentally handicapped, due to a congenital thyroid deficiency, and about 50000 prenatal deaths are occurring annually due to iodine deficiency disorders. Only 5.7% of the households were using iodized salt in Dire Dawa city Administration, which is below the legal requirement.This study assessed availability of adequately iodized salt at household level and associated factors in Dire Dawa town, East Ethiopia. Community based cross-sectional study was carried out among households in Dire Dawa town during March 16-26, 2015. Multistage sampling technique was used. Data were collected using a pretested and structured questionnaire by a face-to-face interview technique. Bivariate and multivariate analyses were performed to check associations and control confounding. A total of 694 participants were participated. The availability of adequately iodized salt (≥15 parts per million) in the study area was 7.5% (95% CI; 5.6-9.5). Multivariate result showed that health information about iodized salt (AOR=8.96, 95% CI; 4.68-17.16) (p=0.03), good knowledge about iodized salt (AOR=9.23, 95% CI; 3.34-25.5) (p=0.01) and using packed salt (AOR=3.99, 95% CI; 1.48-10.73) (p=0.006) were associated with availability of adequately iodized salt at household level. Availability of adequately iodized salt at household level was very low. Hence, households should be sensitized about importance of iodized salt and its proper handling at the household level.

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Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis

BMC Public Health ◽

10.1186/s12889-019-7979-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Kidanemaryam Berhe ◽

Freweini Gebrearegay ◽

Hadush Gebremariam

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Zinc Deficiency ◽

Associated Factors ◽

Meta Analysis ◽

Diet Diversity ◽

Animal Source Foods ◽

Animal Source ◽

Pooled Prevalence ◽

Women And Children

Abstract Background Pregnant women and children are the most vulnerable groups to zinc deficiency. Despite the presence of few primary studies, studies that could provide strong evidence that would help policymakers to develop appropriate interventional strategies in addressing zinc deficiency among pregnant women and children are limited in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the national pooled prevalence and associated factors of zinc deficiency among pregnant women and children. Methods We searched Pub Med, Scopus, CINAHL, Google Scholar, and Google for studies reported on zinc deficiency and associated factors among pregnant women and children. Search terms were ‘zinc deficiency’, ‘zinc status’, ‘associated factors’, ‘children’, ‘pregnant women’, and ‘Ethiopia’ using the boolean operators ‘OR’ or ‘AND’. Searches were using English language. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) checklist was used. Two authors independently reviewed the studies. The effect sizes of the meta-analysis were the prevalence of zinc deficiency and adjusted odds ratio (AOR) of the associated factors. Finally, the Comprehensive Meta-Analysis (CMA) version 3.3.07 was used for statistical analysis by applying the random-effects model and publication bias was assessed using funnel plots and Egger’s test. Results Thirteen studies (7 among pregnant women having total participants of 2371 pregnant women and 6 among children with total participants of 5154 children) were included in this systematic review and meta-analysis. Using the random-effects model, the pooled prevalence of zinc deficiency was 59.9% (95%CI: 51.9, 67.7%) and 38.4% (95%CI: 28.6, 49.4) among pregnant women and children, respectively. The associated factors for zinc deficiency among pregnant women were coffee intake (adjusted odds ratio (AOR) =1.76), low intake of animal source foods (AOR = 2.57), and inadequate diet diversity (AOR = 2.12). Conclusion Overall, zinc deficiency among pregnant women and children is a significant public health concern in Ethiopia. Promoting dietary modification to enhance the bioavailability of zinc, improving diet diversity, and consuming animal source foods would help in alleviating and/or minimizing the problem among the target groups. Zinc supplementation could also be considered for pregnant women and children.

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Alcohol consumption and its associated factors among pregnant women in Sub-Saharan Africa: a systematic review and meta-analysis' as given in the submission system

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-020-00269-3 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Alemu Earsido Addila ◽

Telake Azale Bisetegn ◽

Yigzaw Kebede Gete ◽

Mezgebu Yitayal Mengistu ◽

Getnet Mihretie Beyene

Keyword(s):

Systematic Review ◽

Alcohol Consumption ◽

Alcohol Use ◽

Pregnant Women ◽

Associated Factors ◽

Unplanned Pregnancy ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Pooled Prevalence ◽

Sub Saharan

Abstract Background Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries. Methods The results of the review were reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline and, it was registered in the Prospero database, number CRD42019127103. The available primary studies were collated from different databases: PubMed, CINAHL, Cochrane Library, PsycINFO, Google Scholar, African Journals Online and Centre for Addiction and Mental Health Library. The main search terms were [((alcohol consumption) OR (alcohol drinking) OR (alcohol use) OR (ethanol use) OR (alcohol exposure)) AND ((pregnant women) OR (pregnant mother) OR (during pregnancy)) AND (Sub-Saharan Africa)]. We used the Joanna Briggs Institute (JBI) for critical appraisal of studies. The random-effects model was computed to estimate the pooled prevalence. Heterogeneity between studies was checked using the I2 statistic and the Cochrane Q test. Results The review resulted in 963 original studies after searching various databases, and finally 37 studies in qualitative synthesis and 30 articles in the systematic review and meta-analysis were included. The overall summary estimate of the prevalence of alcohol consumption during pregnancy was found to be 20.83% (95% CI: 18.21, 23.46). The pooled estimate of meta-analysis showed that depression (OR: 1.572; 95% CI: 1.34, 1.845), partners’ alcohol use (OR: 1.32, 95% CI: 1.11, 1.57), knowledge on harmful effect of alcohol consumption (OR: 0.36, 95% CI: 0.29, 0.45) and, unplanned pregnancy (OR: 2.33, 95% CI: 1.17, 4.63) were statistically significant factors with alcohol consumption during pregnancy. Conclusions The result showed that there was high alcohol consumption during pregnancy in Sub- Saharan Africa. Alcohol consumption during pregnancy was associated with depression, partners’ alcohol use, unplanned pregnancy and knowledge of the harmful effects of alcohol consumption. Therefore, this will be a basis for public policy and resource allocation for prevention initiatives.

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Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

Systematic Reviews ◽

10.1186/s13643-021-01786-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Habtamu Geremew ◽

Demeke Geremew

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Associated Factors ◽

Meta Analysis ◽

Regional Analysis ◽

The Other ◽

Transmitted Infection ◽

Other Hand ◽

Pooled Prevalence ◽

History Of

Abstract Background Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors. Methods A comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively. Result We identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68–2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92–3.14%) and 1.90% (95% CI, 0.40–3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86–5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57–2.75) in Amhara and 1.46% (95% CI, 0.69–2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12–0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15–7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35–17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60–1.01%). Conclusion This study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations. Systematic review registration PROSPERO CRD42020211650

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Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-018195 ◽

2018 ◽

Vol 8 (3) ◽

pp. e018195 ◽

Cited By ~ 68

Author(s):

Dhammika D Siriwardhana ◽

Sarah Hardoon ◽

Greta Rait ◽

Manuj C Weerasinghe ◽

Kate R Walters

Keyword(s):

Older Adults ◽

Low Income ◽

Meta Analysis ◽

Community Dwelling ◽

Low Income Countries ◽

Middle Income ◽

Middle Income Countries ◽

Pooled Prevalence ◽

Registration Number ◽

Community Dwelling Older Adults

ObjectiveTo systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs.DesignSystematic review and meta-analysis. PROSPERO registration number is CRD42016036083.Data sourcesMEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017.SettingLow-income and middle-income countries.ParticipantsCommunity-dwelling older adults aged ≥60 years.ResultsWe screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I2=99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I2=97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years.ConclusionThe prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries.PROSPERO registration numberCRD42016036083.

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