scholarly journals Clinical and patient-centered implementation outcomes of mHealth interventions for type 2 diabetes in low-and-middle income countries: a systematic review

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Moses Mokaya ◽  
Florence Kyallo ◽  
Roman Vangoitsenhoven ◽  
Christophe Matthys
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Risk Of Bias ◽  
Patient Centered ◽  
Middle Income ◽  
Middle Income Countries ◽  
Implementation Outcomes ◽  
Percentage Difference ◽  
Low And Middle Income

Abstract Background The prevalence of Type 2 Diabetes is rising in Low- and Middle-Income Countries (LMICs), affecting all age categories and resulting in huge socioeconomic implications. Mobile health (mHealth) is a potential high-impact approach to improve clinical and patient-centered outcomes despite the barriers of cost, language, literacy, and internet connectivity. Therefore, it is valuable to examine the clinical and implementation outcomes of mHealth interventions for Type 2 Diabetes in LMICs. Methods The Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines were applied in framing and reporting the review criteria. A systematic search of Cochrane Library, Web of Science, PubMed, Scopus, and Ovid databases was performed through a combination of search terms. Randomized Controlled Trials (RCTs) and cohort studies published in English between January 2010 and August 2021 were included. Risk of bias for missing results in the included studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Quantitative and qualitative methods were used to synthesize the results. Results The search identified a total of 1161 articles. Thirty studies from 14 LMICs met the eligibility criteria. On clinical outcomes, 12 and 9 studies reported on glycated hemoglobin (HbA1c )and fasting blood glucose (FBG) respectively. Text messages was the most commonly applied mHealth approach, used in 19 out of the 30 studies. Ten out of the 12 studies (83.3%) that reported on HbA1c had a percentage difference of <0.3% between the mHealth intervention and the comparison group. Additionally, studies with longer intervention periods had higher effect size and percentage difference on HbA1c (1.52 to 2.92%). Patient-centred implementation outcomes were reported variedly, where feasibility was reported in all studies. Acceptability was reported in nine studies, appropriateness in six studies and cost in four studies. mHealth evidence reporting and assessment (mERA) guidelines were not applied in all the studies in this review.   Conclusion mHealth interventions in LMICs are associated with clinically significant effectiveness on HbA1 but have low effectiveness on FBG. The application of mERA guidelines may standardize reporting of patient-centered implementation outcomes in LMICs. Trial registration PROSPERO: Registration ID 154209.

scholarly journals Depression and type 2 diabetes in low- and middle-income countries: A systematic review

2014 ◽  
Vol 103 (2) ◽  
pp. 276-285 ◽  
Author(s):  
Emily Mendenhall ◽  
Shane A. Norris ◽  
Rahul Shidhaye ◽  
Dorairaj Prabhakaran
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Coprevalence of type 2 diabetes mellitus and tuberculosis in low-income and middle-income countries: A systematic review

2018 ◽  
Vol 35 (1) ◽  
pp. e3066 ◽  
Author(s):  
Hannah Stowe McMurry ◽  
Emily Mendenhall ◽  
Aravind Rajendrakumar ◽  
Lavanya Nambiar ◽  
Srinath Satyanarayana ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries

scholarly journals Interventions for preventing type 2 diabetes in adults with mental disorders in low and middle income countries

2019 ◽  
Author(s):  
Masuma Pervin Mishu ◽  
Emily J Peckham ◽  
Judy Wright ◽  
Johanna Taylor ◽  
Nilesh Tirbhowan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mental Disorders ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Implementation outcomes of policy and programme innovations to prevent obstetric haemorrhage in low- and middle-income countries: a systematic review

2020 ◽  
Author(s):  
Nessa Ryan ◽  
Dorice Vieira ◽  
Dena Goffman ◽  
Evan M Bloch ◽  
Godwin O Akaba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Implementation Strategies ◽  
Skills Training ◽  
Practical Implementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Implementation Outcomes ◽  
Obstetric Haemorrhage ◽  
Prevention Programmes ◽  
Low And Middle Income

Abstract Globally, obstetric haemorrhage (OH) remains the leading cause of maternal mortality. Much of the associated mortality is ascribed to challenges surrounding deployment of innovations rather than lack of availability. In low- and middle-income countries (LMICs), where the burden is highest, there is a growing interest in implementation research as a means to bridge the ‘know–do’ gap between proven interventions and their reliable implementation at scale. In this systematic review, we identified and synthesized qualitative and quantitative data across the implementation outcomes of OH prevention innovations in LMICs using a taxonomy developed by Proctor et al. We also identified service outcomes for the included innovations, as well as implementation strategies and implementation facilitators and barriers. Eligible studies were empirical, focused on the implementation of OH prevention programmes or policies and occurred in an LMIC. Eight databases were searched. Two authors independently assessed studies for selection and extracted data; the first author resolved discrepancies. Narrative synthesis was used to analyse and interpret the findings. Studies were predominantly focused in Africa and on primary prevention. Interventions included prophylactic use of uterotonics (n = 7), clinical provider skills training (n = 4) and provision of clinical guidelines (n = 1); some (n = 3) were also part of a multi-component quality improvement bundle. Various barriers were reported, including challenges among intervention beneficiaries, providers and within the health system; however, studies reported the development and testing of practical implementation solutions. These included training and monitoring of implementers, community and stakeholder engagement and guidance by external mentors. Some studies linked successful delivery to implementation outcomes, most commonly adoption and acceptability, but also feasibility, penetration and sustainability. Findings suggest that innovations to prevent OH can be acceptable, appropriate and feasible in LMIC settings; however, more research is needed to better evaluate these and other under-reported implementation outcomes.

scholarly journals Effectiveness of technological interventions to improve upper limb motor function in people with stroke in low- and middle-income countries: Protocol for a systematic review and meta-analysis

2020 ◽  
Author(s):  
Meiling Milagros Carbajal-Galarza ◽  
Nathaly Olga Chinchihualpa-Paredes ◽  
Sergio Alejandro Abanto-Perez ◽  
María Lazo-Porras
Keyword(s):  
Systematic Review ◽  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Middle Income ◽  
Middle Income Countries ◽  
Technological Interventions ◽  
Low And Middle Income

ABSTRACTIntroductionStroke is one of the main causes of disability in low- and middle-income countries (LMIC), frequently presenting with upper extremity paresis and causing major functional dependence. It requires high dose and intense rehabilitation which implies high economic costs, consequently limiting this therapy in LMIC. There are multiple technological interventions that facilitate rehabilitation either in intensity, adherence and motor evaluation; or enable access to rehabilitation such as robots, games or virtual reality, sensors, electronic devices and tele-rehabilitation. Their efficacy has been mainly evaluated in high-income countries, hence the importance of conducting a systematic review in LMIC settings.ObjectivesTo measure the efficacy of technological interventions vs. classical physical rehabilitation in the upper extremity motor function in people who had suffered a first or recurrent episode of stroke in LMIC.Methods and analysisThis protocol is consistent with the methodology recommended by the PRISMA-P and the Cochrane handbook for systematic reviews of interventions. We propose to do a systematic review and meta-analysis. In order to do so, we will perform an electronic search in PubMed, Global Index Medicus and Physiotherapy Evidence Database. No date range parameters will be used. Randomized controlled trials (RCT) published in English, Spanish, French and Portuguese, with the primary outcome focusing on upper limb motor function, will be included. Two reviewers will screen all retrieved titles, abstracts and full texts, perform the evaluation of the risk of bias and extract all data independently. The risk of bias of the included RCT will be evaluated by the Cochrane Collaboration’s tool. A qualitative synthesis will be provided in text and tables, to summarize the main results of the selected publications.The heterogeneity between studies will be assessed through the I2 statistic. If there is sufficient homogeneity across outcomes, a meta-analysis will be considered. The outcomes to be evaluated will be motor functionality of the upper extremity, performance for activities of daily living and quality of life, through measurement scales.ConclusionsThis systematic review will provide evidence regarding the efficacy of multiple technological interventions to improve motor function of upper extremity in individuals with stroke in LMIC. Based on this analysis, we will be able to assess whether these interventions are also effective and feasible in the recovery of functionality after stroke in low- and middle-income countries, and thus offer recommendations in these areas.

scholarly journals Mobile health interventions for HIV/STI prevention among youth in low- and middle-income countries (LMICs): a systematic review of studies reporting implementation outcomes

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
Chisom Obiezu-Umeh ◽  
Thembekile Shato ◽  
Florida Uzoaru ◽  
Stacey Mason ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Implementation Science ◽  
Mobile Health ◽  
Science Literature ◽  
Middle Income ◽  
Sti Prevention ◽  
Middle Income Countries ◽  
Implementation Outcomes ◽  
Low And Middle Income

Abstract Background Advances and proliferation of technologies such as mobile phones may provide opportunities to improve access to HIV/STI services and reach young people with high risk for HIV and STI. However, the reach, uptake, and sustainability of mobile health (mHealth) HIV/STI interventions targeting young people aged 10–24 years in low- and middle-income countries (LMICs) are largely unknown. To address this gap and to inform implementation science research, a review was conducted to summarize what is known, and what we need to know about implementing mhealth interventions for HIV/STI prevention targeting young people in LMICs. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this review. Drawing upon Proctor’s eight implementation outcome measures, we evaluated the acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability of  m-health HIV/STI interventions targeting young people in LMICs. The search was performed from September 2020–January 2021 and updated on March 1, 2021, in Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, SCOPUS, Global Health, and Web of Science. Eligible studies were required to include an HIV/STI prevention outcome, target young people aged 10–24 years, include a comparison/control group, and reporting of atleast one implementation outcome as outlined by Proctor. Results A total of 1386 articles were located, and their titles and abstracts were screened. Of these, 57 full-text articles were reviewed and subsequently, and 11 articles representing 6 unique interventions were included in the systematic review. Acceptability 6 (100%), appropriateness 6 (100%), and feasibility 5(83%) were the most frequently evaluated implementation outcomes. Adoption 2 (33%), fidelity 1 (17%), and cost 1 (17%) were rarely reported; penetration and sustainability were not reported. Conclusions This review contributes to implementation science literature by synthesizing key implementation outcomes of mHealth HIV/STI interventions targeting young people in LMICs. Future research is needed on m-health HIV/STI implementation outcomes, particularly the penetration, cost, and long-term sustainability of these interventions. Doing so will enhance the field’s understanding of the mechanisms by which these interventions lead or do not lead to changes in high HIV/STI risk and vulnerability among young people in LMICs.

scholarly journals Booster Dose of Bacille Calmette-Guérin Vaccine for Tuberculosis in Low and Middle-Income Countries: A Systematic Review

2021 ◽  
Vol 7 (3) ◽  
pp. 235-252
Author(s):  
OA Oduwole ◽  
JP Mwankon ◽  
J Okebe ◽  
EB Esu ◽  
M Chibuzor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Booster Dose ◽  
Risk Of Bias ◽  
Bcg Vaccine ◽  
Bacille Calmette Guerin ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomised Controlled ◽  
Tuberculosis Disease ◽  
Low And Middle Income

Background: The Bacille Calmette-Guérin (BCG) vaccine, given as a single dose, offers variable protection against Tuberculosis (TB). It is plausible that repeat doses could improve the effectiveness of the BCG vaccine in settings where the population remain at risk of the disease. Objective: To assess the effectiveness of BCG revaccination as a booster dose in preventing TB in Low- and Middle- Income Countries (LMICs). Methods: We searched the electronic databases without language or publication restrictions and followed the procedures for preparing systematic reviews, including assessing the risk of bias as outlined in the Cochrane handbook. We included randomised controlled trials (RCTs) conducted in LMICs involving children and adults receiving one or more BCG vaccine doses after the primary BCG vaccination. The incidence of severe forms of TB, active TB and adverse events were the primary outcomes. Results: Five RCTs were included in this systematic review. Revaccination with BCG probably makes little or no difference to the risk of active TB measured after five years (Relative risk (RR) 1.16, 95% CI 0.88 to 1.51; 348,083 participants; one study, moderate certainty evidence) or nine years post-revaccination (RR 0.96, 95% CI 0.82 to 1.12; 348,083 participants; one study, moderate certainty evidence). In populations with HIV co-infection, revaccination probably increases the risk of pulmonary tuberculosis compared to placebo (RR 1.74, 95% CI 1.00 to 3.01; 46,764 participants; one study, moderate certainty evidence). Conclusion: The available evidence suggests that BCG revaccination probably makes little or no difference in preventing tuberculosis disease in LMICs.

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