Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

Abstract Background: Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa.Objective: The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa.Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies.Result: A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I2= 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I2= 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I2= 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I2= 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I2= 11.7% ;P=0.337) were identified factors of pneumonia.Conclusions: The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

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Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

10.21203/rs.2.23015/v1 ◽

2020 ◽

Author(s):

Biruk Beletew Abate ◽

Melaku Getahun Bimrew ◽

Ayelign Mengesha Kasie ◽

Mesfin Kassaw Wudu ◽

Molla Azmeraw

Keyword(s):

East Africa ◽

Associated Factors ◽

Meta Analysis ◽

Eastern Africa ◽

Systemic Review ◽

Cochrane Library ◽

Under Five ◽

Under Five Children ◽

The Impact ◽

National Prevalence

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

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Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis, 2019

10.21203/rs.2.13740/v1 ◽

2019 ◽

Author(s):

Biruk Beletew ◽

Ayelign Kassie ◽

Mesfin Wudu kassaw ◽

Mikias Amare Getu

Keyword(s):

East Africa ◽

Neonatal Sepsis ◽

Associated Factors ◽

Meta Analysis ◽

Home Delivery ◽

Eastern Africa ◽

Cochrane Library ◽

Inverse Variance ◽

Pooled Prevalence ◽

National Prevalence

Abstract Background: Neonatal sepsis is one of the most leading causes of inflated death and illness of neonates. Different primary studies in Eastern Africa showed the burden of neonatal sepsis. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of neonatal sepsis from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result: A total of 26 studies with 11239 participants were used for analysis. The pooled prevalence of neonatal sepsis in East Africa was 29.65% (95% CI; 23.36–35.94).Home delivery(AOR =2.67; 95% CI: 1.15-4.00; I2= 0.0%; P=0.996), maternal history of UTI (AOR=2.083; 95% CI :0.24-3.93; I2= 69.1%; P=0.001),gestational age (preterm) (AOR=1.56; 95% CI: 1.04-2.08; I2= 27.8%;P=0.000) ,prolonged labor (AOR=3.23 ;95% CI: -0.04-6.51; I2= 62.7%; P=0.020) and PROM (AOR= 1.95; 95% CI: 0.53-3.37; I2= 43.2%; P=0.062) were identified factors of neonatal sepsis. Conclusions: The prevalence of neonatal sepsis in Eastern Africa remains high. This review may help policy-makers and program officers to design neonatal sepsis preventive interventions. Keywords: Neonatal sepsis, Eastern Africa

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Prevalence of pneumonia and its associated factors among under-five children in East Africa: a systematic review and meta-analysis

BMC Pediatrics ◽

10.1186/s12887-020-02083-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Biruk Beletew ◽

Melaku Bimerew ◽

Ayelign Mengesha ◽

Mesfin Wudu ◽

Molla Azmeraw

Keyword(s):

Systematic Review ◽

East Africa ◽

Associated Factors ◽

Meta Analysis ◽

Under Five ◽

Under Five Children

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Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis, 2019

10.21203/rs.2.13554/v1 ◽

2019 ◽

Author(s):

Biruk Beletew Abate ◽

Ayelign Mengesha Kasie ◽

Mesfin Kassaw ◽

Mikiyas Amare Getu

Keyword(s):

East Africa ◽

Neonatal Sepsis ◽

Associated Factors ◽

Meta Analysis ◽

Home Delivery ◽

Eastern Africa ◽

Cochrane Library ◽

Inverse Variance ◽

Pooled Prevalence ◽

History Of

Abstract Background : Neonatal sepsis is one of the leading causes of inflated death and illness of neonates. Different primary studies in Eastern Africa showed the burden of neonatal sepsis. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review intended to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Methods : Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that assessed the prevalence and associated factors of neonatal sepsis from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to determine the prevalence and the effect size of associated factors. The subgroup analysis was done by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result : A total of 26 studies with 11239 participants were used for analysis. The pooled prevalence of neonatal sepsis in East Africa was 29.65% (95% CI; 23.36–35.94).Home delivery(AOR =2.67; 95% CI: 1.15-4.00; I 2 = 0.0%; P=0.996), maternal history of UTI (AOR=2.083; 95% CI :0.24-3.93; I 2 = 69.1%; P=0.001),gestational age (preterm) (AOR=1.56; 95% CI: 1.04-2.08; I 2 = 27.8%;P=0.000) ,prolonged labor (AOR=3.23 ;95% CI: -0.04-6.51; I 2 = 62.7%; P=0.020) and PROM (AOR= 1.95; 95% CI: 0.53-3.37; I 2 = 43.2%; P=0.062) were identified factors of neonatal sepsis. Conclusions : The prevalence of neonatal sepsis in Eastern Africa remains high. This review may help policy-makers and program officers to design neonatal sepsis preventive interventions.

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Poor glycemic control and associated factors among diabetic patients in Ethiopia; A Systemic review and meta-analysis

10.1101/19004986 ◽

2019 ◽

Author(s):

Berhane Fseha Teklehaimanot ◽

Abadi kidanemariam Berhe ◽

Gebrehiwot Gebremariam Welearegawi

Keyword(s):

Glycemic Control ◽

Low Income ◽

Associated Factors ◽

Meta Analysis ◽

Group Analysis ◽

Poor Glycemic Control ◽

Systemic Review ◽

Cochrane Library ◽

Diabetic Patients ◽

Optimum Level

AbstractIntroductionThe major global public health problems now days are diabetes especially the burden is high in low income countries including Ethiopia due to the limited resource for screening and early diagnosis of the diabetes. To prevent diabetic complications including organ damage and micro vascular complications blood glucose level should be maintained at an optimum level. However there was no pooled national picture on poor glycemic control and its associated factors.MethodsDifferent data base searching engine including PubMed, Google scholar, the Cochrane library, MEDLINE,, HINARY and African journal online (AJOL) were used. The Joanna Briggs Critical Appraisal Tools and Newcastle Ottawa scale for assessing the quality of cross sectional studies were used for quality assessment. The meta-analysis was conducted using STATA 14 software. I2 statistic and egger weighted regression were used to assess heterogeneity and publication bias.ResultsA total of 134 studies were identified from different database searching engines and other sources. After removing for duplication, absence of abstract and review of the full text 12 studies were including in the meta-analysis. The pooled prevalence of poor glycemic control among diabetic patients in Ethiopia is 64.72% with 95% confidence interval 63.16-66.28%. The sub group analysis of poor glycemic control among diabetic patients in different region of the country shows consistent and high prevalence of poor glycemic control ranging from 62.5% in Tigray region to 65.6% in Oromia region of the country. Residence, dyslipidemia and diet adherence were significantly association with poor glycemic control among diabetic patients in Ethiopia.ConclusionThe prevalence of poor glycemic control among diabetic patients was high in Ethiopia and consistent across different regions of the country. The most important factors associated with poor glycemic factor among diabetic patients were being rural residence, having dyslipidemia and not adhering to dietary plan.

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Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000588 ◽

2020 ◽

Vol 35 (4) ◽

pp. 372-381

Author(s):

Junhong Wang ◽

Hua Zhang ◽

Zongxuan Zhao ◽

Kaifeng Wen ◽

Yaoke Xu ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Neurological Outcome ◽

Meta Analysis ◽

Systemic Review ◽

Cochrane Library ◽

Significant Difference ◽

Bystander Cardiopulmonary Resuscitation ◽

The Impact ◽

Hospital Cardiac Arrest

AbstractObjective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

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Magnitude, bacterial etiology profile and associated factors of surgical site infection in Ethiopia: Systematic review and meta-analysis

10.21203/rs.2.13405/v1 ◽

2019 ◽

Author(s):

Mizan Kindu ◽

Esayas Aklilu Zeleke ◽

Baye Gelaw Tarekegn ◽

Feleke Moges Yehuala

Keyword(s):

Surgical Site Infection ◽

Rural Areas ◽

Associated Factors ◽

Meta Analysis ◽

Surgical Site Infections ◽

Cochrane Library ◽

Site Infection ◽

Inverse Variance ◽

Pooled Prevalence ◽

National Prevalence

Abstract Background: Surgical site infection is the third most commonly reported nosocomial infection. Different primary studies on Surgical site infection (SSI) were conducted in Ethiopia. However, variation among those studies was seen. This study was aimed to estimate the national prevalence of SSI, its bacterial profile and associated factors of SSI in Ethiopia. Methods: PubMed, Cochrane library, and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted inverse variance random-effects model was applied to estimate the national prevalence of SSI, its bacterial profile and the effect size of associated factors. The subgroup analysis was conducted by region, study design, and year of study conducted. Result: A total of 18 studies were used for prevalence of SSI, its bacterial profile and associated factors. The pooled prevalence of SSI was 11.58 (95% CI 9.78, 13.38). The pooled prevalence of culture positive SSI infection among patients who develop clinical sign and symptoms of SSI was also 80.42% (95% CI 70.86, 89.99). SSI was majorly caused by S. aureus (28.47%) and E. coli (15.93%). Drinking an alcohol (AOR = 6.28; 95%CI: 2.9–13.3); women’s having chorioaminities (AOR = 8.67; 95%CI: 4.63–16.27); patients living in rural areas (AOR = 3.10; 95%CI: 1.57–6.14); patients who undergo previous surgery (AOR = 3.94; 95%CI: 1.7–7.17) and women’s who had rupture of membrane >12 hour (AOR=5.29; 95%CI: 2.73–10.25) were identified factors of SSI. Conclusions: The prevalence of SSI in Ethiopia was high. This indicates calling for the need of better allocating resources and implementing a program for controlling Surgical site infections in Ethiopia.

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Impact of spontaneous hepatocellular carcinoma rupture on surgical outcome after liver resection: a systemic review and meta-analysis

10.21203/rs.2.19071/v2 ◽

2020 ◽

Author(s):

Wei Zhang ◽

Zhi-Yong Huang ◽

Chang Shu

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Recurrence Rate ◽

Surgical Outcome ◽

Meta Analysis ◽

Systemic Review ◽

Cochrane Library ◽

Tumor Rupture ◽

Significant Difference ◽

The Impact

Abstract Background Spontaneous tumor rupture is a rare but life-threatening complication of hepatocellular carcinoma (HCC). The impact of spontaneous ruptured HCC on long-term survival after liver resection (LR) remains unclear. Our aim was to compare the surgical outcome in patients who underwent LR with ruptured and non-ruptured HCC . Methods A comprehensive search using PubMed, Embase, Cochrane Library and Science Citation Index Expanded databases was performed. The primary outcomes were the hazard ratio (HR) for overall survival ( OS) and disease free survival (DFS). The secondary outcomes included morbidity, hospital mortality and recurrence rate . Results Ten retrospective studies including 3222 patients met the inclusion criteria. Pooled analysis revealed a significantly poorer OS and DFS for patients with ruptured HCC compared to patients with non-ruptured HCC (HR, 2.02; 95% CI, 1.61-2.54; P< 0.00001 and HR, 1.92; 95% CI, 1.56-2.35; P<0.00001, respectively). In the subgroup analysis, both the propensity score matching (PSM) and non-PSM studies demonstrated a significantly poorer OS in the ruptured HCC group (P=0.02 and P<0.00001, respectively). However, meta-analysis of two PSM studies showed that there was not significant difference in the DFS between the two groups (P=0.50). Patients in the ruptured HCC group had a higher mortality and recurrence rate than the non-ruptured HCC group, but the difference was not significant (P = 0.05 and P = 0.06, respectively) Conclusions Surgical outcomes of the patients with the ruptured or non-ruptured HCC undergoing LR were not only affected by tumor rupture itself, but also by the tumor characteristics and liver functional status. Therefore, classifying all ruptured but resectable HCC as T4 stage is unable to accurately represent their true prognosis.

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Association of indoor microbial aerosols with respiratory symptoms among under-five children: a systematic review and meta-analysis

Environmental Health ◽

10.1186/s12940-021-00759-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Adekunle Gregory Fakunle ◽

Nkosana Jafta ◽

Rajen N. Naidoo ◽

Lidwien A. M. Smit

Keyword(s):

Relative Risk ◽

Respiratory Symptoms ◽

Meta Analysis ◽

Random Effect ◽

Potential Effect ◽

Cochrane Library ◽

Under Five ◽

Under Five Children ◽

Increased Risk ◽

Microbial Exposure

Abstract Background Despite the recognition of the importance of indoor microbial exposures on children’s health, the role of different microbial agents in development and aggravation of respiratory symptoms and diseases is only poorly understood. This study aimed to assess whether exposure to microbial aerosols within the indoor environment are associated with respiratory symptoms among children under-5 years of age. Methods A systematic literature search was conducted on PubMed, Web of Science, GreenFILE, ScienceDirect, EMBASE and Cochrane library through February 2020. Studies that investigated the exposure–response relationship between components of the indoor microbial communities and respiratory symptoms among under-five children were eligible for inclusion. A random-effect meta-analysis was applied to estimate pooled relative risk (RR) and 95% confidence interval (CI) for study specific high versus low microbial exposures. The potential effect of individual studies on the overall estimate was evaluated using leave-one-out analysis, while heterogeneity was evaluated by I2 statistics using RevMan 5.3. Results Fifteen studies were eligible for inclusion in a meta-analysis. The pooled risk estimate suggested that increased microbial exposure was associated with an increased risk of respiratory symptoms [pooled relative risk (RR): 1.24 (1.09, 1.41), P = 0.001]. The association was strongest with exposure to a combination of Aspergillus, Penicillium, Cladosporium and Alternaria species [pooled RR: 1.73 (1.30, 2.31), P = 0.0002]. Stratified analysis revealed an increased risk of wheeze [pooled RR: 1.20 (1.05, 1.37), P = 0.007 and allergic rhinitis [RR: 1.18 (0.94, 1.98), P = 0.16] from any microbial exposure. Conclusions Microbial exposures are, in general, associated with risk of respiratory symptoms. Future studies are needed to study the indoor microbiome more comprehensively, and to investigate the mechanism of these associations.

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Prevalence and factors associated with malaria among under-five children in Ethiopia: A Systematic review and Meta-analysis Protocol

10.21203/rs.3.rs-28903/v1 ◽

2020 ◽

Author(s):

Abay Woday ◽

Mulluken Dessalegn ◽

Setognal Birara ◽

Kusse Urmale

Keyword(s):

Systematic Review ◽

Associated Factors ◽

Statistical Significance ◽

Grey Literature ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Under Five ◽

Under Five Children ◽

Pooled Prevalence

Abstract Background: The Sub-Saharan African countries have been carried 80% of the global burden of malaria. Consequently, malaria is still the leading cause of under-five mortality in developing nations. In Ethiopia, studies conducted regarding prevalence and associated factors of malaria among under five children are inconsistently reported and highly variable.Objective: to determine the pooled prevalence and associated factors of malaria among under five children in Ethiopia. Methods: The protocol for this review is registered at PROSPERO with registration number: CRD42020157886. A comprehensive search of the following electronic databases were made using: MEDLINE, EMBASE, CINAHL, Scopus, web science, HINARI, Cochrane library, Google Scholar and maternity & infant care databases as well as grey literature uploaded at Ethiopian Health Development Journal were searched until May 2020. The quality of studies will be assessed using Joanna Briggs Institute (JBI) checklist. All identified observational studies reporting the prevalence of malaria and associated factors among under five children in Ethiopia will be considered. Three reviewers will screen all retrieved articles, conduct data extraction, and then critically appraise all identified studies. The analysis of data will be done using STATA 14.0 statistical software. We will determine the pooled prevalence and determinants of malaria among under five children using random effect model with effect size and 95% confidence interval. Heterogeneity among the included studies will be assessed through the Cochrane Q-test statistics and I2 test. Furthermore, publication bias will be checked using funnel plot and egger’s test. Finally, statistical significance level will be declared at a p-value less than 0.05. Discussion: The result from this systematic review will inform and guide health policy planners and researchers on the burden, and determinants of under five children malaria in Ethiopia. To our knowledge, this is the first systematic review in Ethiopia. We will synthesize the findings to generate up-to-date knowledge on malaria among under five children in Ethiopia.

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