Sociodemographic inequities associated with participation in leisure-time physical activity in sub-Saharan Africa: an individual participant data meta-analysis

Abstract Background Despite the numerous studies on hypertension, the current literature reveals little about the relationship between patient comorbidities and uncontrolled hypertension in sub-Saharan Africa (SSA). We aimed to assess the associations between body size, dyslipidemia, diabetes and uncontrolled hypertension. Methods We harmonised and pooled individual-level data from 25 cross-sectional studies. We did a meta-analysis of individual participant data to assess the association between uncontrolled hypertension with body size, diabetes and dyslipidemia using a logistic regression while adjusting for potential confounders. Results The pooled dataset included 107,339 participants, of whom 64,811 were women and 42,528 were men. The pooled prevalence of uncontrolled hypertension (UHTN) among those on treatment was (3,449) 59.89%. The UHTN estimate ranged from 47.0% in Malawi to 80.0% in Guinea. Significant association were noted between UHTN and diabetes for all countries. The overall pooled estimate for UHTN among patients with diabetes was OR = 1.49 (95% CI 1.30 to 1.67). All countries had significant associations between UHTN and central obesity except for Gambia, Kenya and Tanzania. Study participants from Uganda with central obesity had the highest likelihood of UHTN OR = 1.14 (95% CI 0.38 to 1.89). All countries had significant associations between UHTN and general obesity except for Kenya, Tanzania and Uganda. Conclusions The prevalence of uncontrolled hypertension among patients with comorbidities is high in SSA. Key messages Effective strategies to improve blood pressure control among patients with chronic comorbidities are needed.

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Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies

PLoS Medicine ◽

10.1371/journal.pmed.1002511 ◽

2018 ◽

Vol 15 (2) ◽

pp. e1002511 ◽

Cited By ~ 42

Author(s):

Elizabeth A. Torrone ◽

Charles S. Morrison ◽

Pai-Lien Chen ◽

Cynthia Kwok ◽

Suzanna C. Francis ◽

...

Keyword(s):

Hiv Prevention ◽

Bacterial Vaginosis ◽

Sexually Transmitted Infections ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Individual Participant Data ◽

Sexually Transmitted ◽

Prevention Studies ◽

Individual Participant ◽

Sub Saharan

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Can socioeconomic health differences be explained by physical activity at work and during leisure time? Rationale and protocol of the active worker individual participant meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-023379 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023379 ◽

Cited By ~ 3

Author(s):

Pieter Coenen ◽

Maaike A Huysmans ◽

Andreas Holtermann ◽

Richard Troiano ◽

Paul Jarle Mork ◽

...

Keyword(s):

Physical Activity ◽

Socioeconomic Status ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Meta Analysis ◽

Mediating Effect ◽

Physically Active ◽

Health Differences ◽

Individual Participant ◽

Active Worker

IntroductionSocioeconomic health differences have often been described, but remain insufficiently understood. Recent evidence suggests that workers who are high (compared with low) physically active at work are less healthy. Moreover, workers who are highly physically active at work are predominantly physically inactive during leisure time. These observations suggest that workers with a lower socioeconomic status may be exposed to negative health consequences of occupational physical activity and may only benefit to a limited extent from health benefits of leisure-time physical activity. Physical activity may therefore be an important driver of socioeconomic health differences. We describe the rationale and protocol of the active worker study, an individual participant data meta-analysis aimed at exploring socioeconomic health differences by differential doses of physical activity at work and leisure time.Methods and analysisUsing database and scoping searches (we searched in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews from database inception to 14 September 2017), we have identified 49 published and unpublished prospective studies in which the association of occupational and leisure-time physical activity with cardiovascular or all-cause mortality was assessed. Principal investigators of these studies will be invited to participate in the active worker consortium, after which data will be retrieved. After data merging and harmonising, we will perform multilevel survival analysis assessing the combined association of occupational and leisure-time physical activity with mortality. We will also test the mediating effect of physical activity on the association of socioeconomic status and mortality (ie, socioeconomic health differences).DiscussionThe Medical Ethical Committee of the VU University Medical Center has declared, according to Dutch legislation, that the ‘Dutch Medical Research Involving Human Subjects Act’ does not apply to the current study. As such, no ethics approval is required. We intent to publish outcomes of the active worker Study in scientific peer-reviewed journals.PROSPERO registration numberCRD42018085228.

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Correction: Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies

PLoS Medicine ◽

10.1371/journal.pmed.1002608 ◽

2018 ◽

Vol 15 (6) ◽

pp. e1002608 ◽

Cited By ~ 4

Author(s):

Elizabeth A. Torrone ◽

Charles S. Morrison ◽

Pai-Lien Chen ◽

Cynthia Kwok ◽

Suzanna C. Francis ◽

...

Keyword(s):

Hiv Prevention ◽

Bacterial Vaginosis ◽

Sexually Transmitted Infections ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Individual Participant Data ◽

Sexually Transmitted ◽

Prevention Studies ◽

Individual Participant ◽

Sub Saharan

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Diet and physical activity in pregnancy to prevent gestational diabetes: a protocol for an individual participant data (IPD) meta-analysis on the differential effects of interventions with economic evaluation

BMJ Open ◽

10.1136/bmjopen-2020-048119 ◽

2021 ◽

Vol 11 (6) ◽

pp. e048119

Author(s):

Dyuti Coomar ◽

Jonathan M Hazlehurst ◽

Frances Austin ◽

Charlie Foster ◽

Graham A Hitman ◽

...

Keyword(s):

Physical Activity ◽

Cost Effectiveness ◽

Gestational Diabetes ◽

Systematic Reviews ◽

Meta Analysis ◽

Individual Participant Data ◽

Randomised Trials ◽

Diet And Physical Activity ◽

Individual Participant ◽

In Pregnancy

IntroductionMothers with gestational diabetes mellitus (GDM) are at increased risk of pregnancy-related complications and developing type 2 diabetes after delivery. Diet and physical activity-based interventions may prevent GDM, but variations in populations, interventions and outcomes in primary trials have limited the translation of available evidence into practice. We plan to undertake an individual participant data (IPD) meta-analysis of randomised trials to assess the differential effects and cost-effectiveness of diet and physical activity-based interventions in preventing GDM and its complications.MethodsThe International Weight Management in Pregnancy Collaborative Network database is a living repository of IPD from randomised trials on diet and physical activity in pregnancy identified through a systematic literature search. We shall update our existing search on MEDLINE, Embase, BIOSIS, LILACS, Pascal, Science Citation Index, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Health Technology Assessment Database without language restriction to identify relevant trials until March 2021. Primary researchers will be invited to join the Network and share their IPD. Trials including women with GDM at baseline will be excluded. We shall perform a one and two stage random-effect meta-analysis for each intervention type (all interventions, diet-based, physical activity-based and mixed approach) to obtain summary intervention effects on GDM with 95% CIs and summary treatment–covariate interactions. Heterogeneity will be summarised using I2 and tau2 statistics with 95% prediction intervals. Publication and availability bias will be assessed by examining small study effects. Study quality of included trials will be assessed by the Cochrane Risk of Bias tool, and the Grading of Recommendations, Assessment, Development and Evaluations approach will be used to grade the evidence in the results. A model-based economic analysis will be carried out to assess the cost-effectiveness of interventions to prevent GDM and its complications compared with usual care.Ethics and disseminationEthics approval is not required. The study is registered on the International Prospective Register of Systematic Reviews (CRD42020212884). Results will be submitted for publication in peer-reviewed journals.

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