scholarly journals Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis

PLoS Medicine ◽  
2020 ◽  
Vol 17 (6) ◽  
pp. e1003139 ◽  
Author(s):  
Giorgia Sulis ◽  
Pierrick Adam ◽  
Vaidehi Nafade ◽  
Genevieve Gore ◽  
Benjamin Daniels ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Antibiotic Prescription ◽  
Meta Analysis ◽  
Middle Income ◽  
Prescription Practices ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Under detection of depression in primary care settings in low and middle-income countries: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Abebaw Fekadu ◽  
Mekdes Demissie ◽  
Rahel Berhane ◽  
Girmay Medhin ◽  
Teserra Bitew ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Sample Size ◽  
Meta Analysis ◽  
Screening Tools ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Care Clinicians ◽  
Detection Of Depression ◽  
Low And Middle Income

ABSTRACTObjectiveDepression is the commonest mental disorder in primary care but is poor identified. The objective of this review was to determine the level of detection of depression by primary care clinicians and its determinants in studies from low-and middle-income countries (LMICs).MethodsDesignSystematic review and meta-analysis. Review protocol was registered in the PROSPERO database (CRD42016039704).DatabasesPubMed, PsycINFO, Medline, EMBASE, LILAC and AJOL.Quality assessmentRisk of bias within studies evaluated with the Effective Public Health Practice Project (EPHPP).Synthesis“Gold standard” diagnosis for the purposes of this review were based on the 9-item Patient Health Questionnaire (PHQ-9; cutoff scores of 5 and 10), structured interview or expert diagnosis. Meta-analysis was conducted excluding studies on special populations. Analysis of pooled data were stratified by diagnostic approaches.ResultsA total of 2223 non-duplicate publications were screened. Ten publications, from two multi-country studies and eight single country studies, making 18 country level reports, were included. One of the multi-country studies used an enriched sample of screen positive participants. Overall methodological quality of the studies was good. Depression detection was 0.0% in five reports and <12% in another five. The pooled detection for two reports that used PHQ-9 at a cutoff point of 5 (combined sample size = 1426) was 3.9% (95% CI = 2.3%, 5.5%); in the four reports that used PHQ-9 cutoff score of 10 (combined sample size =5481), the pooled detection was 7.0% (95% CI = 3.9%, 10.2%). For the enriched sample, the pooled detection was 43.5 % (95% CI: 25.7%, 61.0%). Severity of depression and suicidality were significantly associated with detection.ConclusionsThe extremely low detection of depression by primary care clinicians poses a serious threat to scaling up mental healthcare in LMICs. Interventions to improve detection should be prioritized.Strength and limitation of study▸This is the first review of detection of depression in LMIC settings▸The review was comprehensive in terms of databases searched▸Screening tools were used as gold standards, which may lead to overestimation of prevalence and underestimation of detection▸The small number of studies and the use of different instruments and cutoff▸points precluded exploration of sources of heterogeneity▸The review does not include studies on distress or sub-threshold depression

scholarly journals Seroprevalence of SARS CoV-2 infection in Low and Middle-Income Countries and risk classification in the context of rolling out vaccine candidate across these countries : Protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Martin Ackah ◽  
Louise Ameyaw ◽  
Kwadwo Owusu Akuffo ◽  
Cynthia Osei Yeboah ◽  
Nana Esi Wood ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Vaccine Candidate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

Abstract Background Seroprevalence of SARS Cov-2 provides a good indication of the extent of exposure and spread in the population, as well as those likely to benefit from a vaccine candidate. To date, there is no published or ongoing systematic review on the seroprevalence of COVID-19 in Low- and Middle-Income Countries (LMICs). This systematic review and meta-analysis will estimate SARS Cov-2 seroprevalence and the risk factors for SARS Cov-2 infection in LMICs.Methods We will search PubMed, EMBASE, WHO COVID-19 Global research database, Google Scholar, the African Journals Online, LILAC, HINARI, medRxiv, bioRxiv and Cochrane Library for potentially useful studies on seroprevalence of COVID-19 in LMICs from December 2019 to December 2020 without language restriction. Two authors will independently screen all the articles, select studies based on pre-specified eligibility criteria and extract data using a pre-tested data extraction form. Any disagreements will be resolved through discussion between the authors. The pooled seroprevalence of SARS CoV-2 for people from LMICs will be calculated. Random effects model will be used in case of substantial heterogeneity in the included studies, otherwise fixed-effect model will be used. A planned subgroup, sensitivity and meta-regression analyses will be performed. For comparative studies, the analyses will be performed using Review Manager v 5.4; otherwise, STATA 16 will be used. All effect estimates will be presented with their confidence intervals.Discussion The study will explore and systematically review empirical evidence on SARS Cov-2 seroprevalence in LMICs, and to assess the risk factors for SARS Cov-2 infection in Low Middle Income Countries in the context of rolling out vaccines in these countries. Finally, explore risk classifications to help with the rolling out of vaccines in LMICs.Systematic review registration: The protocol for this review has been registered in PROSPERO (CRD422020221548).

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