scholarly journals Poor blood pressure control and its associated factors among peoples living with Diabetes Mellitus in sub-Saharan Africa: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Yonas Akalu ◽  
Yigizie Yeshaw ◽  
Getayeneh Antehunegn Tesema ◽  
Sofonyas Abebaw Tiruneh ◽  
Achamyeleh Birhanu Teshale ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Associated Factors ◽  
Meta Analysis ◽  
Pressure Control ◽  
Sub Saharan Africa ◽  
Random Effects Model ◽  
Pooled Prevalence ◽  
Poor Blood Pressure Control ◽  
Sub Saharan

Abstract Background Poor blood pressure control among people living with diabetes mellitus (DM) is one of the primary causes of cardiovascular complications and death in sub-Saharan Africa (SSA). However, there is paucity of evidence on the prevalence and associated factors of poor blood pressure control in SSA. Therefore, this review aimed to estimate the prevalence and its associated factors among people living with DM in SSA. Methods We systematically searched PubMed, African Journals online, Hinari, Google scholar and direct Google to access observational studies conducted in SSA. Microsoft excel spreadsheet was used to extract the data and then exported into STATA/MP version 16.0 for further analysis. Heterogeneity across studies was checked using Cochrane Q test statistic and I2 test and small study effect were checked using Funnel plot symmetry and Egger’s statistical test at 5% significant level. A random-effects model was used to estimates the pooled prevalence of poor blood pressure control with a 95% confidence interval (CI). Results Of the 1,043 articles retrieved, 21 articles with an overall sample size of 6308 were eligible for the meta-analysis. After performing random-effects model, the pooled prevalence of poor blood pressure control was 69.8% (95% CI: 63.43, 76.25%). Poor adherence to antihypertensive treatment (OR = 1.7; 95% CI: 1.03–2.80, I2 = 0.0%, p = 0.531) and overweight (OR = 2.4, 95% CI: 1.57–3.68, I2 = 0.00%, p = 0.47) were significantly associated with poor blood pressure control. Conclusions Only one third of diabetic patients in SSA had achieved target blood pressure. Hence, there is an urgent need for initiatives to improve and control hypertension, and preventive measures should concentrate on modifiable risk factors. Systematic Review registrations: The review protocol has been registered in PROSPERO with protocol number of CRD42020187901.

scholarly journals Alcohol consumption and its associated factors among pregnant women in Sub-Saharan Africa: a systematic review and meta-analysis' as given in the submission system

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Alemu Earsido Addila ◽  
Telake Azale Bisetegn ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal Mengistu ◽  
Getnet Mihretie Beyene
Keyword(s):  
Systematic Review ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Associated Factors ◽  
Unplanned Pregnancy ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Pooled Prevalence ◽  
Sub Saharan

Abstract Background Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries. Methods The results of the review were reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline and, it was registered in the Prospero database, number CRD42019127103. The available primary studies were collated from different databases: PubMed, CINAHL, Cochrane Library, PsycINFO, Google Scholar, African Journals Online and Centre for Addiction and Mental Health Library. The main search terms were [((alcohol consumption) OR (alcohol drinking) OR (alcohol use) OR (ethanol use) OR (alcohol exposure)) AND ((pregnant women) OR (pregnant mother) OR (during pregnancy)) AND (Sub-Saharan Africa)]. We used the Joanna Briggs Institute (JBI) for critical appraisal of studies. The random-effects model was computed to estimate the pooled prevalence. Heterogeneity between studies was checked using the I2 statistic and the Cochrane Q test. Results The review resulted in 963 original studies after searching various databases, and finally 37 studies in qualitative synthesis and 30 articles in the systematic review and meta-analysis were included. The overall summary estimate of the prevalence of alcohol consumption during pregnancy was found to be 20.83% (95% CI: 18.21, 23.46). The pooled estimate of meta-analysis showed that depression (OR: 1.572; 95% CI: 1.34, 1.845), partners’ alcohol use (OR: 1.32, 95% CI: 1.11, 1.57), knowledge on harmful effect of alcohol consumption (OR: 0.36, 95% CI: 0.29, 0.45) and, unplanned pregnancy (OR: 2.33, 95% CI: 1.17, 4.63) were statistically significant factors with alcohol consumption during pregnancy. Conclusions The result showed that there was high alcohol consumption during pregnancy in Sub- Saharan Africa. Alcohol consumption during pregnancy was associated with depression, partners’ alcohol use, unplanned pregnancy and knowledge of the harmful effects of alcohol consumption. Therefore, this will be a basis for public policy and resource allocation for prevention initiatives.

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

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.

scholarly journals Effect of Therapeutic Group Education on Adherence and Blood Pressure Control among Uncontrolled Hypertensive Patients in Sub Saharan Africa

2018 ◽  
Vol 08 (03) ◽  
pp. 183-195 ◽  
Author(s):  
Chris Nadège Nganou-Gnindjio ◽  
Héloïse Guidelle Kenmogne Domning ◽  
Liliane Mfeukeu-Kuate ◽  
Bâ Hamadou ◽  
Félicité Kamdem ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Sub Saharan Africa ◽  
Therapeutic Group ◽  
Group Education ◽  
Hypertensive Patients ◽  
Sub Saharan

scholarly journals Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis

2020 ◽  
Vol 8 ◽  
pp. 205031212091924
Author(s):  
Assefa Desalew ◽  
Tilayie Feto Gelano ◽  
Agumasie Semahegn ◽  
Biftu Geda ◽  
Tilahun Ali
Keyword(s):  
Hearing Impairment ◽  
21St Century ◽  
Associated Factors ◽  
Meta Analysis ◽  
Population Characteristics ◽  
Sub Saharan Africa ◽  
Hearing Level ◽  
Suppurative Otitis Media ◽  
Pooled Prevalence ◽  
Sub Saharan

Background: Childhood hearing impairment is still a significant cause of disability in the 21st century in developing countries. Particularly, the burden is more severe in sub-Saharan Africa, where the majority of children with hearing problems is living. Thre are great variations and inconsistencies of available findings conducted in sub-Saharan Africa. Hence, the aim of this review was to determine the pooled prevalence of childhood hearing impairment and its associated factors in sub-Saharan Africa. Methods: Studies were searched from main databases (PubMed, CINAHL, and African Journals Online), Google Scholar, and other relevant sources using electronic and manual techniques. All observational studies, written in English and conducted among participants (aged less than 18 years) from 2000 to 2018, were eligible. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of the funnel plot. Statistical analysis was carried out to determine pooled prevalence using Stata version 14. In addition, subgroup analysis was carried out for the normality criteria of hearing thresholds and characteristics of the study populations. Results: The pooled prevalence of hearing impairment was 10% (95% confidence interval (CI): 9%–11%). The magnitude of hearing impairment varies with the normality criterion used. The most commonly used threshold was 25 and 30 dB hearing level. The prevalence of hearing impairment based on normality criterion (>20 dB, >25 dB, >30 dB, and >35 dB) were 17%, 19%, 2%, and 1%, respectively. While in the questionnaire-based evaluation, the prevalence was 6% (95% CI: 3%–9%). In addition, based on population characteristics, the prevalence of hearing impairment for school or community-based children was 6% (95% CI: 5%–7%) while the prevalence for children with comorbidities was 23% (95% CI: 15%–31%). Chronic suppurative otitis media, impacted cerumen, advanced stage of human immunodeficiency virus, tuberculosis infection, and age of the children were associated with hearing impairment in sub-Saharan Africa. Conclusion: Hearing impairment in children and adolescents in sub-Saharan Africa was high, and associated with preventable and treatable risk factors.

scholarly journals Prevalence of Depression among Epileptic Patients and its Association with Drug Therapy: A Systematic Review and Meta-Analysis

2018 ◽  
Author(s):  
Getenet Dessie ◽  
Henok Mulugeta ◽  
Cheru Tessema Leshargie ◽  
Fasil Wagnew ◽  
Sahai Burrowes
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Random Effects Model ◽  
Pooled Prevalence ◽  
Prevalence Of Depression ◽  
Epileptic Patients ◽  
Sub Saharan ◽  
Patients With Epilepsy

AbstractBackgroundDespite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. This systematic review and meta-analysis aims to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa.MethodsA systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) identified peer-reviewed research studies and doctoral dissertations on the prevalence of depression among patients with epilepsy using pre-defined quality and inclusion criteria. Relevant data were extracted and descriptive summaries of the studies presented in tabular form. The I2 test was used to assess heterogeneity across studies. A random effects model was used to estimate the pooled prevalence of comorbidity at a 95% confidence interval (CI). Funnel plot asymmetry and Egger’s tests were used to check for publication bias. The final effect size was determined by applying a trim and fill analysis in a random-effects model.ResultsOur search identified 167 studies, of which 16 articles were eligible for inclusion the final analysis. The pooled estimate of prevalence of depression among patients with epilepsy was 32.71 (95% CI: 25.50 - 39.91). Regional sub-group analysis found that the pooled prevalence in East Africa was 34.52 (95% CI: 23.53 - 45.51) and 29.69 (95% CI: 22.7 - 36.68) in Southern and West Africa. The odds of depression among epileptic patients receiving polytherapy were 2.65 higher than in those receiving monotherapy (95% CI: 1.49 - 4.71, I2=79.1%, p < 0.05).ConclusionOur findings indicate high comorbidity in sub-Saharan Africa and suggests that it may be more prevalent there than elsewhere. Comorbidity is statistically associated with polytherapy. Given the high levels of epilepsy in the region, more attention should be paid to incorporating depression screening and treatment into existing epilepsy programs and to revising treatment guidelines on comorbid depression to reduce polytherapy.

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

2020 ◽  
Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma: ◽  
Alemayehu Molla ◽  
Moges Mareg
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Nutritional Assessment ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Care Plan ◽  
Under Nutrition ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
The Impact

Abstract Background: In developing world including sub-Saharan Africa, HIV/AIDS has worsened the impact of under-nutrition in children. HIV infected children are highly vulnerable to malnutrition. Even though under-nutrition screening and intervention are incorporated into the care plan of HIV infected children, it is continued as a major problem for HIV infected children in Africa. Hence, the main aim of this systematic review and meta-analysis was to estimate the pooled prevalence of under-nutrition and associated factors among children infected with HIV.Methods: Primary studies were retrieved from PubMed/ MEDLINE online, Science direct, and Hinari databases. We found a total of 1847 records from these databases. After removing papers my using different exclusion criteria, 26 studies that report the prevalence of under-nutrition were included. We used a standardized data extraction format prepared in Microsoft Excel. STATA- version 14 statistical software was used for analysis. Heterogeneity was evaluated through I2 test. A random-effects meta-analysis model was used to estimate the pooled prevalence of under-nutrition and its associated factors. The summary estimates were also presented using Forest plots and tables.Results: The pooled prevalence of stunting, underweight, and wasting in HIV infected children were 51.4% (95% CI: 46.3, 56.4), 39.0% (95% CI: 33.7, 44.3), and 24.5% (95% CI: 19.2, 29.8) respectively. Household insecurity was associated with stunting [OR= 5.50 (95% CI 3.36, 8.98]. Low family economic status [OR= 5.25 (95% CI: 2.52, 10.92)])], feeding frequency [OR= 0.32 (95% CI 0.172, 0.605)] and caretakers attending dietary counseling [OR= 0.367 (95% CI: 0.182, 0.739)] were significantly associated with under-weight among HIV infected children. Conclusions: The pooled prevalence of under-nutrition among HIV infected children was high. Routine nutritional assessment and nutritional support shall be strengthened, monitored, and evaluated in HIV infected children. Implementation of policies and strategy sated by a national and international stakeholder in ART care centers should get maximum emphasis to reduce undernutrition in HIV infected children.

scholarly journals Evening anti-hypertensive dosing improves blood pressure control and reduce cardiovascular events in hypertensive: a meta-analysis of 40 trials in 44,167 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.P Sunjaya ◽  
A.F Sunjaya
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Control ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Pressure Control ◽  
Controlled Trials ◽  
Night Time ◽  
Randomized Controlled

Abstract Introduction Nocturnal blood pressure (BP) and early morning BP surge have consistently been found to be a better prognostic marker of cardiovascular outcome than daytime BP. Most anti-hypertensive show greater blood pressure-lowering effect in the first 12 hours compared to the next 12 hours. Several prospective studies have shown better BP regulation and improved cardiovascular risk when anti-hypertensive are ingested at bedtime versus at awakening. Purpose In patients with hypertension does evening dosing of anti-hypertensive compared to morning dosing led to better reduction in pressure, blood pressure control and reduced cardiovascular morbidity. Methods A meta-analysis was performed based on randomized controlled trials obtained from Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline and Medline ahead of print published between 2000 and 2020. Main outcome measures include mean 24 hour systolic and diastolic blood pressure, cardiovascular events as well as prevalence of blood pressure in control. Data synthesis and analysis was done using RevMan 5.3 using a random effects model. Results A total of 40 randomized controlled trials, representing 44,167 patients were included in this meta-analysis. Most studies evaluate the administration of mixed anti-hypertensive with ≥1 medication ingested at bedtime, calcium channel blockers (CCBs) or angiotensin receptor blockers (ARBs) with sample sizes ranging from 30 to 19,084 patients. Evening administration of anti-hypertensive was found to significantly lower 24-hour systolic blood pressure (Mean difference = −1.05, 95% CI: −2.01 to −0.10, p=0.03) and 24-hour diastolic blood pressure (Mean difference = −1.09, 95% CI: −1.68 to −0.50, p=0.0003). Prevalence of controlled blood pressure was found to significantly increase with evening dosing (RR=1.15, 95% CI: 1.03 to 1.28, p=0.01). Significant reduction in cardiovascular events were found in the evening dosing group (RR=0.48, 95% CI: 0.03 to 0.68, p=&lt;0.00001). Discussion Reduction in night-time blood pressure especially among non-dippers as reported in previous studies and higher prevalence of controlled blood pressure may explain the greater than 50% reduction in cardiovascular events in the evening dosing group. This marked benefit from a simple and inexpensive strategy certainly has great potential to benefit patients in practice. Even so, few studies have reported the prevalence of blood pressure in control (9 studies) and cardiovascular events (6 studies). Few has also studied this in geriatric populations where night-time hypotension and hypoperfusion may bring the most impact. Conclusion For patients with hypertension, evening dosing significantly improves blood pressure control and reduces the risk for cardiovascular events. Careful selection of anti-hypertensive administration time in patients is recommended given the possible benefits. Anti Hypertensive Dosing Forest Plot Funding Acknowledgement Type of funding source: None

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