scholarly journals A systematic review of in-patients’ antimicrobial prescriptions and status of antimicrobial stewardship programmes in Nigerian hospitals

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chinonyerem O. Iheanacho ◽  
Uchenna I. H. Eze

Abstract Background Antimicrobial resistance is a major consequence of irrational antimicrobial prescriptions and consumptions, but this can be prevented by antimicrobial stewardship. The study systematically reviewed available evidence on antimicrobial prescriptions and antimicrobial stewardship (AMS) programmes in Nigerian hospitals. This will provide insight to the extent of required interventions, for improved healthcare. Main body Published research from January 1 2010 to March 31 2021 from PubMed, Scopus, Web of Science, African Journals Online and Google scholar databases was reviewed using Preferred Regulatory Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2009. Studies that reported antimicrobial use and antimicrobial stewardship programmes in Nigerian hospitals within the period in focus were assessed for eligibility. The National Heart, Lung and Blood Institute (NHLBI) quality assessment tool was used to assess quality of included studies. Among 15 studies included based on inclusion criteria, 12 reported on antimicrobial prescriptions and 3 reported on status of antimicrobial stewardship programmes in Nigerian hospitals. Most studies reported high prevalence of antimicrobials prescriptions with broad spectrum antimicrobials, majority of which were inappropriate. Empirical antimicrobial prescribing was common, and this was mostly done with less cognisance to existing guidelines. Only few hospitals were observed to have formal AMS teams in Nigeria. Conclusion Inappropriate prescribing of antimicrobials was common among prescribers in Nigeria. Although there was paucity of studies on status of AMS, the available few showed very low prevalence of AMS teams in hospitals. There is urgent need for implementation of AMS in Nigerian hospitals, to enhance rational antimicrobial use. Meanwhile more research on AMS in Nigerian hospitals is needed.

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Chinonyerem O. Iheanacho ◽  
Uchenna I. H. Eze ◽  
Emmanuel A. Adida

Abstract Background High effectiveness of COVID-19 vaccines is essential for the pandemic control. This study systematically reviewed available evidence on effectiveness of ChAdOx1 and BNT162b2 vaccines in the general population, for improved vaccine policies and strategies. Main body of the abstract Using several keywords, a search of Scopus, PubMed, Google scholar and Hinari databases was conducted from December 1, 2020 to June 9, 2021. Eligible studies comprising original studies reporting effectiveness of the vaccines, were included following PRISMA guidelines. Individual studies were assessed for quality using National Heart, Lung and Blood Institute quality assessment tool. A total of 1766 titles were retrieved and 11 were included, out of which only 5 were peer-reviewed. Although data availability was limited, studies suggest equivalent effectiveness of BNT162b2 and ChAdOx1 COVID-19 vaccine against SARS-CoV-2 infection and COVID-19 related morbidity and mortality. Vaccine effectiveness increased steadily to about 35 days, with an enhanced effectiveness following the second dose. Short conclusion BNT162 and ChAdOx1 vaccines were associated with equivalent and high effectiveness which increased with time and a second dose in the general population. This encourages continued practice of other preventive measures, particularly during the first week of vaccination, and reinforces the need for a second dose.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034554
Author(s):  
Zhihan Chen ◽  
Rui Wang ◽  
Min Zhang ◽  
Yitong Wang ◽  
Yulan Ren

IntroductionOpioid use disorder (OUD) is a worldwide health problem. Clinical trials indicated that acupuncture combined with medication is effective in OUD, however, there are different conclusions presented by previous trials. This study is designed to evaluate the efficacy and safety of acupuncture combined with medication in OUD.Methods and analysisPubMed, CENTRAL, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation and Theses, AMED, OpenGrey, Clinicaltrials.gov and who.int/trialsearch will be searched in September 2019 without a language restriction. Randomised controlled trials (RCTs) and quasi-RCTs which included participants with OUD receiving acupuncture therapy combined with medication versus control group will be included in this study. Two reviewers will independently screen studies, extract data, assess risk of bias by the Cochrane risk of bias assessment tool and assess quality of evidence by Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Any disagreements will be arbitrated by the third reviewer. Data synthesis and analysis will be conducted by using RevMan V.5.3. Subgroup analyses, sensitivity analysis, meta-regression and reporting bias assessment will be conducted if necessary and appropriate.Ethics and disseminationOn account of the nature of this systematic review and meta-analysis, ethical approval is not required. The results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019123436.


2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.


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