Linkage to HIV care following diagnosis in the WHO European Region: A systematic review and meta-analysis, 2006-2017

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

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Mental health and retention in HIV care: A systematic review and meta-analysis.

Health Psychology ◽

10.1037/hea0000606 ◽

2018 ◽

Vol 37 (6) ◽

pp. 574-585 ◽

Cited By ~ 19

Author(s):

Cherie R. Rooks-Peck ◽

◽

Adebukola H. Adegbite ◽

Megan E. Wichser ◽

Rebecca Ramshaw ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Meta Analysis ◽

Hiv Care ◽

Retention In Hiv Care

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Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis

AIDS and Behavior ◽

10.1007/s10461-021-03551-y ◽

2021 ◽

Author(s):

Vasiliki Papageorgiou ◽

Bethan Davies ◽

Emily Cooper ◽

Ariana Singer ◽

Helen Ward

Keyword(s):

Systematic Review ◽

Social Determinants ◽

Meta Analysis ◽

Hiv Treatment ◽

Material Deprivation ◽

Hiv Care ◽

People Living With Hiv ◽

Hiv Care Continuum ◽

Care Continuum ◽

Living With Hiv

AbstractDespite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.

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Under-nutrition and associated factors among children infected with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis

Archives of Public Health ◽

10.1186/s13690-021-00785-z ◽

2022 ◽

Vol 80 (1) ◽

Author(s):

Jemberu Nigussie ◽

Bekahegn Girma ◽

Alemayehu Molla ◽

Moges Mareg ◽

Esmelealem Mihretu

Keyword(s):

Systematic Review ◽

Associated Factors ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Hiv Care ◽

Clinical Staging ◽

Under Nutrition ◽

Pooled Prevalence ◽

Sub Saharan ◽

Hiv Aids

Abstract Background In the developing world, such as the sub-Saharan African region, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to under-nutrition. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition, and the pooled effect sizes of associated factors among HIV-infected children in sub-Saharan Africa. Methods The primary studies for this review were retrieved from PubMed/ MEDLINE online, Science Direct, Hinari, web of science, CINHAL, EMBASE, WHO databases, Google, and Google Scholar databases. The articles selected for this meta-analysis were published between 2010 and 2020. The last search date was 18 October 2021. The data was extracted in Microsoft Excel format and exported to STATA Version 14.0. A random effect meta-analysis model was used. Heterogeneity was evaluated by the I2 test. The Egger weighted regression test was used to assess publication bias. Results We retrieved 847 records from these databases. Of which records, 813 were excluded due to different reasons and 34 studies were included in the final analysis. The pooled prevalence of stunting, underweight and wasting in HIV infected children was 46.7% (95% CI; 40.36–53.07, I2 = 98.7%, p < 0.01), 35.9% (95% CI; 30.79–41.02, I2 = 97.4% p < 0.01), and 23.0% (95% CI; 18.67–27.42, I2 = 96.9%, p < 0.01) respectively. The advanced WHO HIV/AIDS clinical staging (III&IV) [OR = 6.74 (95%: 1.747, 26.021), I2 = 94.7%] and household food insecurity were associated with stunting [OR = 5.92 (95% CI 3.9, 8.87), I2 = 55.7%]. Low family economic status [OR = 4.737 (95% CI: 2.605, 8.614), I2 = 31.2%] and increased feeding frequency [OR = 0.323 (95% CI: 0.172, 0.605), I2 = 69.8%] were significantly associated with under-weight. Anemia [OR = 2.860 (95% CI: 1.636, 5.000), I2 = 74.8%] and diarrhea in the previous month [OR = 4.117 (95% CI: 2.876, 5.894), I2 = 0.0%] were also associated with wasting among HIV infected children in sub-Saharan Africa. Conclusions The pooled prevalence of under-nutrition among HIV infected children was high. Nutritional assessment and interventions need great attention as a part of HIV care for HIV positive children. The implementation of policies and strategies established by national and international stakeholders in ART care centres should take a maximum emphasis on reducing under-nutrition among HIV infected children.

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Discontinuation from Antiretroviral Therapy: A Continuing Challenge among Adults in HIV Care in Ethiopia: A Systematic Review and Meta-Analysis

PLoS ONE ◽

10.1371/journal.pone.0169651 ◽

2017 ◽

Vol 12 (1) ◽

pp. e0169651 ◽

Cited By ~ 12

Author(s):

Hailay Abrha Gesesew ◽

Paul Ward ◽

Kifle Woldemichael Hajito ◽

Garumma Tolu Feyissa ◽

Leila Mohammadi ◽

...

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Meta Analysis ◽

Hiv Care

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Effective interventions to improve young adults’ linkage to HIV care in Sub-Saharan Africa: a systematic review

AIDS Care ◽

10.1080/09540121.2017.1306637 ◽

2017 ◽

Vol 29 (10) ◽

pp. 1198-1204 ◽

Cited By ~ 11

Author(s):

Bertille Octavie Mavegam ◽

Jennifer R. Pharr ◽

Patricia Cruz ◽

Echezona E. Ezeanolue

Keyword(s):

Systematic Review ◽

Young Adults ◽

Sub Saharan Africa ◽

Hiv Care ◽

Effective Interventions ◽

Sub Saharan ◽

Linkage To Hiv Care

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Prevalence and trends of thinness, overweight and obesity among children and adolescents aged 3–18 years across Europe: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-018241 ◽

2017 ◽

Vol 7 (12) ◽

pp. e018241 ◽

Cited By ~ 4

Author(s):

Miriam Garrido-Miguel ◽

Iván Cavero-Redondo ◽

Celia Álvarez-Bueno ◽

Fernando Rodriguez-Artalejo ◽

Luis Moreno Aznar ◽

...

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Weight Status ◽

Task Force ◽

Meta Analysis ◽

Overweight And Obesity ◽

European Region ◽

Cochrane Library ◽

Public Health Issue ◽

Childhood And Adolescence

IntroductionIncreasing prevalence of both thinness and excess weight during childhood and adolescence is a significant public health issue because of short-term health consequences and long-term tracking of weight status. Monitoring weight status in Europe may serve to identify countries and regions where rates of these disorders are either slowing down or increasing to evaluate recent policies aimed at appropriate body weight, and to direct future interventions. This study protocol provides a standardised and transparent methodology to improve estimating trends of thinness, overweight and obesity in children aged 3–18 years and adolescents across the European region between 2000 and 2017.Methods and analysisThis protocol is guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the Cochrane Collaboration Handbook. To identify relevant studies, a search will be conducted in MEDLINE, EMBASE, Cochrane Library, CINAHL and Web of Science databases. From the selected studies, relevant references will be screened as supplemental sources. Finally, open search in websites from health institutions will be conducted to identify weight status data not published in scientific journals. Cross-sectional, follow-up studies and panel surveys reporting weight status (objectively measured height and weight) according to the International Obesity Task Force criteria, and written in English or Spanish will be included. Subgroup analyses will be carried out by gender, age, study year and country or European region.DiscussionThis study will provide a comprehensive description of weight status of children and adolescents across Europe from 2000 to 2017. The results will be disseminated in a peer-reviewed journal. This study will use data exclusively from published research or institutional literature, so institutional ethical approval is not required.PROSPERO registration numberCRD42017056917.

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