scholarly journals The differential impact of pediatric COVID-19 between high-income countries and low- and middle-income countries: A systematic review of fatality and ICU admission in children worldwide

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246326
Author(s):  
Taito Kitano ◽  
Mao Kitano ◽  
Carsten Krueger ◽  
Hassan Jamal ◽  
Hatem Al Rawahi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pediatric Population ◽  
Case Fatality ◽  
High Income ◽  
Regional Variability ◽  
Middle Income ◽  
Icu Admission ◽  
Middle Income Countries ◽  
Registration Number ◽  
Low And Middle Income

Background The overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown. Methods To evaluate the magnitude of global COVID-19 death and intensive care unit (ICU) admission in children aged 0–19 years, a systematic review was conducted for articles and national reports as of December 7, 2020. This systematic review is registered with PROSPERO (registration number: CRD42020179696). Results We reviewed 16,027 articles as well as 225 national reports from 216 countries. Among the 3,788 global pediatric COVID-19 deaths, 3,394 (91.5%) deaths were reported from low- and middle-income countries (LMIC), while 83.5% of pediatric population from all included countries were from LMIC. The pediatric deaths/1,000,000 children and case fatality rate (CFR) were significantly higher in LMIC than in high-income countries (HIC) (2.77 in LMIC vs 1.32 in HIC; p < 0.001 and 0.24% in LMIC vs 0.01% in HIC; p < 0.001, respectively). The ICU admission/1,000,000 children was 18.80 and 1.48 in HIC and LMIC, respectively (p < 0.001). The highest deaths/1,000,000 children and CFR were in infants < 1 year old (10.03 and 0.58% in the world, 5.39 and 0.07% in HIC and 10.98 and 1.30% in LMIC, respectively). Conclusions The study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.

scholarly journals Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027851
Author(s):  
Maximilian Salcher-Konrad ◽  
Huseyin Naci ◽  
David McDaid ◽  
Suvarna Alladi ◽  
Deborah Oliveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Secondary Analysis ◽  
Routine Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cochrane Database ◽  
Registration Number ◽  
Meta Analyses ◽  
Low And Middle Income

IntroductionThere are more people living with dementia in low- and middle-income countries (LMICs) than in high-income countries. Evidence-based interventions to improve the lives of people living with dementia and their carers are needed, but a systematic mapping of methodologically robust studies in LMICs and synthesis of the effectiveness of dementia interventions in these settings is missing.Methods and analysisA systematic review and meta-analysis will be conducted to answer the question: Which dementia interventions were shown to be effective in LMICs and how do they compare to each other? Electronic database searches (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit, Cochrane Database of Systematic Reviews) will be complemented by hand searching of reference lists and local knowledge of existing studies from an international network of researchers in dementia from LMICs. Studies will be eligible for inclusion if they were published between 2008 and 2018, conducted in LMICs and evaluated the effectiveness of a dementia intervention using a study design that supports causal inference of the treatment effect. We will include both randomised and non-randomised studies due to an anticipated low number of well-conducted randomised trials in LMICs and potentially greater external validity of non-randomised studies conducted in routine care settings. In addition to narrative synthesis of the interventions, feasibility of pairwise and network meta-analyses will be explored to obtain pooled effects of relative treatment effects.Ethics and disseminationSecondary analysis of published studies, therefore no ethics approval required. Planned dissemination channels include a peer-reviewed publication as well as a website, DVD and evidence summaries.Prospero registration numberCRD42018106206.

scholarly journals Timing of Pubertal Milestones in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 (4) ◽  
pp. 951-959 ◽  
Author(s):  
Jenna L Moodie ◽  
Susan C Campisi ◽  
Kristen Salena ◽  
Megan Wheatley ◽  
Ashley Vandermorris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Tanner Stage ◽  
High Income ◽  
Age At Menarche ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

ABSTRACT Despite increasing global attention to adolescent health in low- and middle-income countries (LMICs), limited literature exists on the timing of pubertal development in these settings. This study aimed to determine the age at menarche (AAM) and age of puberty onset [female Tanner Stage Breast 2 (B2) and male Tanner Stage Genital 2 (G2)] among healthy adolescents living in LMICs. It also aimed to explore the impact of nutritional status on pubertal timing in this population. MEDLINE, Embase, Cochrane CENTRAL, Web of Science, Scopus, and grey literature databases were searched. Observational studies and control arms of randomized controlled trials (RCTs) with healthy participants from LMICs born in or after 1998 were included. Pooled estimates with 95% CIs were calculated by random-effects meta-analyses using the DerSimonian and Laird inverse variance method for each pubertal milestone and by BMI category subgroups. Twenty-seven studies were included in the meta-analysis, representing 90,188 adolescents (78.3% female). Pooled mean estimates for AAM for normal, thin, and overweight BMI groupings were 12.3 y (95% CI: 12.1, 12.5), 12.4 y (95% CI: 12.2, 12.6), and 12.1 y (95% CI: 11.7, 12.5), respectively. For Tanner Stage B2, pooled mean age estimates for normal, thin, and overweight BMI groupings were 10.4 y (95% CI: 9.2, 11.6), 10.2 y (95% CI: 9.3, 11.4), and 8.4 y (95% CI: 6.8, 10.0), respectively. Finally, for Tanner Stage G2, pooled mean estimates for normal, thin, and overweight BMI groupings were 11.0 y (95% CI: 10.3, 11.7), 11.3 y (95% CI: 9.8, 12.9), and 10.3 y (95% CI: 10.0, 10.6), respectively. Data on the timing of pubertal milestones has traditionally come from high-income settings. In this systematic review of contemporary data from adolescents in LMICs, AAM, as well as age at pubertal onset, were similar to those reported from high-income settings.

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