scholarly journals Prevalence of burnout among university students in low- and middle-income countries: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256402
Author(s):  
Mark Mohan Kaggwa ◽  
Jonathan Kajjimu ◽  
Jonathan Sserunkuma ◽  
Sarah Maria Najjuka ◽  
Letizia Maria Atim ◽  
...  
Keyword(s):  
University Students ◽  
Web Of Science ◽  
Meta Analysis ◽  
Maslach Burnout Inventory ◽  
Middle Income ◽  
Middle Income Countries ◽  
Key Population ◽  
Pooled Prevalence ◽  
Funnel Plots ◽  
Low And Middle Income

Background Burnout is common among university students and may adversely affect academic performance. Little is known about the true burden of this preventable malady among university students in low-and-middle-income countries (LMICs). Objectives This study aimed to systematically estimate the prevalence of burnout among university students in LMICs. Methods We searched PubMed, Google Scholar, CINAHL, Web of Science, African Journals Online, and Embase from the inception of each database until February 2021. Original studies were included. No study design or language restrictions were applied. A random-effects meta-analysis was performed using STATA version 16.0. Heterogeneity and publication bias were assessed using Q-statistics and funnel plots, respectively. Results Fifty-five unique articles, including a total of 27,940 (Female: 16,215, 58.0%) university students from 24 LMICs were included. The Maslach Burnout Inventory (MBI) was used in 43 studies (78.2%). The pooled prevalence of burnout was 12.1% (95% Confidence Interval (CI) 11.9–12.3; I2 = 99.7%, Q = 21,464.1, p = < 0.001). The pooled prevalence of emotional exhaustion (feelings of energy depletion), cynicism (negativism), and reduced professional efficacy were, 27.8% (95% CI 27.4–28.3; I2 = 98.17%. p = <0.001), 32.6 (95% CI: 32.0–33.1; I2: 99.5%; p = < 0.001), and 29.9% (95% CI: 28.8–30.9; I2: 98.1%; p = < 0.001), respectively. Conclusion Nearly one-third of university students in LMICs experience burnout. More studies are needed to understand the causes of burnout in this key population. There is a need to validate freely available tools for use in these countries.

scholarly journals Self-Medication with Antibiotics among University Students in LMIC: A systematic review and meta-analysis

2019 ◽  
Vol 13 (08) ◽  
pp. 678-689 ◽  
Author(s):  
Rixiang Xu ◽  
Tingyu Mu ◽  
Guan Wang ◽  
Jing Shi ◽  
Xin Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
University Students ◽  
Meta Analysis ◽  
Antibiotic Use ◽  
Self Medication ◽  
Middle Income ◽  
Inappropriate Use ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Pooled Prevalence

Introduction: Self-medication with antibiotics (SMA) is common among university students in low and middle-income countries (LMICs). However, there has been no meta-analysis and systematic review in the population. Methodology: A literature search was conducted using PubMed, Embase and Web of Science for the period from January 2000 to July 2018. Only observational studies that had SMA among university students from LMICs were included. A random-effects model was applied to calculate the pooled effect size with 95% confidence interval (CI) due to the expected heterogeneity (I2 over 50%). Results: The pooled prevalence of SMA of overall included studies was 46.0% (95% CI: 40.3% to 51.8%). Africa had the highest pooled prevalence of SMA among university students (55.30%), whereas South America had the lowest prevalence (38.3%). Among individual LMICs, the prevalence of SMA among university students varied from as low as 11.1% in Brazil to 90.7% in Congo. Conclusions: The practice of SMA is a widespread phenomenon among university students in LMICs and is frequently associated with inappropriate use. Effective interventions such as medication education and stricter governmental regulation concerning antibiotic use and sale are required to be established in order to deal with SMA properly.

scholarly journals Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Zebenay Workneh Bitew ◽  
Ayinalem Alemu ◽  
Ermias Getaneh Ayele ◽  
Zelalem Tenaw ◽  
Anmut Alebel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
General Population ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Obese Population ◽  
Low And Middle Income

Abstract Background Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. Methods Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. Conclusion This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.

scholarly journals The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Zahra Kiani ◽  
Masoumeh Simbar ◽  
Sepideh Hajian ◽  
Farid Zayeri
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Middle Income ◽  
Infertile Women ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Prevalence Of Depression ◽  
Low And Middle Income

Abstract Background Infertile women’s mental health problems, including depression, are key fertility health issues that affect infertile women more severely than infertile men. Depression may threaten the health of individuals and reduce the quality of their lives. Considering the role and impact of depression on responses to infertility treatments, a systematic review and meta-analysis were conducted to investigate the prevalence of depression symptoms among infertile women. Methods International databases (PubMed, Cochrane Library, Web of Sciences, Scopus, Embase, and PsycINFO), national databases (SID and Magiran), and Google Scholar were searched by two independent reviewers for articles published from 2000 to April 5, 2020. The search procedure was performed in both Persian and English using keywords such as “depression,” “disorders,” “infertility,” “prevalence,” and “epidemiology.” The articles were evaluated in terms of their titles, abstracts, and full texts. The reviewers evaluated the quality of the articles using the Newcastle–Ottawa Scale, after which they analyzed the findings using STATA version 14. The I2 and Egger’s tests were performed to examine heterogeneity and publication bias, respectively. Results Thirty-two articles were subjected to the meta-analysis, and a random effects model was used in the examination given the heterogeneity of the articles. The samples in the reviewed studies encompassed a total of 9679 infertile women. The lowest and highest pooled prevalence rates were 21.01% (95% confidence interval [CI]: 15.61–34.42), as determined using the Hospital Anxiety and Depression Scale, and 52.21% (95% CI: 43.51–60.91), as ascertained using the Beck Depression Inventory, respectively. The pooled prevalence values of depression among infertile women were 44.32% (95% CI: 35.65–52.99) in low- and middle-income countries and 28.03% (95% CI: 19.61–36.44) in high-income countries. Conclusion The prevalence of depression among infertile women was higher than that among the general population of a given country. Especially in low- and middle-income countries, appropriate measures, planning, and policy that target the negative effects of depression on infertile women’s lives should be established to reduce related problems.

scholarly journals Financial toxicity of cancer care in low and middle-income countries: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Andrew Donkor ◽  
Vivian Della Atuwo-Ampoh ◽  
Frederick Yakanu ◽  
Eric Torgbenu ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Meta Analysis ◽  
Cost Of Care ◽  
Financial Toxicity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Low And Middle Income

Abstract Introduction: The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low and middle-income countries (LMICs) is scarce.Aim: To identify the extent of cancer-related financial toxicity and how it has been measured in LMICs.Methods: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to: costs; and determinants of financial toxicity.Results: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of financial toxicity was 56.96% [95% CI, 30.51, 106.32]. In sub-group meta-analyses, the financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Mean medical costs per cancer patients were $2,740.18 [95% CI, $1,953.62, $3,526.74]. The ratio of cost of care to gross domestic product (GDP) per capita varied considerably across the LMICs included in this review, which ranged from 0.06 in Vietnam to 327.65 in Ethiopia.Conclusions: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.

scholarly journals Metabolic Syndrome Among Children and Adolescents in Low and Middle Income Countries: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Zebenay Workneh Bitew ◽  
Ayinalem Alemu ◽  
Ermias Getaneh Ayele ◽  
Zelalem Tenaw ◽  
Anmut Alebel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
General Population ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Obese Population ◽  
Low And Middle Income

Abstract Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is raising the low and middle income countries (LMICs). There are various studies with inconsistent findings, but they are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. Methods: Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result: In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among the overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. Conclusion: This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.

scholarly journals The use of non-prescribed antibiotics; prevalence estimates in low-and-middle-income countries. A systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Neusa F. Torres ◽  
Buyisile Chibi ◽  
Desmond Kuupiel ◽  
Vernon P. Solomon ◽  
Tivani P. Mashamba-Thompson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bacterial Resistance ◽  
Negative Impact ◽  
Meta Analysis ◽  
Self Medication ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Low And Middle Income

Abstract Background The global increase in the utilization of non - prescribed antibiotics (NPA), is concerning, with high persistence within the low and middle-income countries (LMICs). With a negative impact on the health of individuals and communities the use of NPA paves the way to the  propagation of superbugs that potentially predisposes to changes in bacterial resistance patterns, antibiotic resistance (AR) and antimicrobial resistance (AMR). This study aimed at estimating through a systematic review and meta-analysis, the prevalence of NPA utilisation and describe its primary sources in LMICs. Methods The study is a systematic review and meta-analysis which study protocol was registered in PROSPERO (CRD42017072954). The review used The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.  The studies searched in databases were deemed eligible if reported evidence of practices of self-medication with antibiotics (SMA) and the prevalence of NPA utilisation within adult participants from LMICs, published between 2007 to 2017. The pooled analyses were carried out using Meta XL statistical software. The pooled prevalence was calculated with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool. Results The review included a total of 11 cross-sectional studies, involving 5080 participants and conducted in LMICs from Asia (India, Laos, Nepal, Pakistan, Sri Lanka and Yemen), Latin America (Guatemala), Africa (Nigeria). All studies reported existing  practices of SMA, with reported prevalence ranging from 50% to 93,8%. The pooled prevalence of SMA was 78% (95% CI: 65–89%). The main sources of NPA were; pharmacies, family and friends, old prescriptions, home cabinet and leftover antibiotics. Conclusion This study revealed a high prevalence of utilisation of NPA in the studied LMICs, these were found to be twice as high in women than men and those participants aged between 18 and 40 years old. The review suggests f considering broader qualitative and comprehensive contextuallized research to better understand the nuances of NPA use. These would be benefitial to uncover uncover gray areas, inform decisions, support the (re) design and implementation of multifaceted interventions towards antibiotic stewardship and conservancy in LMICs.

scholarly journals Metabolic syndrome among children and adolescents in Low and Middle Income Countries: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Zebenay Workneh Bitew ◽  
Ayinalem Alemu ◽  
Ermias Getaneh Ayele ◽  
Zelalem Tenaw ◽  
Anmut Alebel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
General Population ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Obese Population ◽  
Low And Middle Income

Abstract Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs.Methods: Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result: In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females.Conclusion: This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.

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