scholarly journals Determinants of Perinatal Birth Asphyxia Among Preterm Babies in Ethiopia: A Systematic Review and Meta-Analysis of Observational Studies Protocol

2020 ◽  
Author(s):  
Abay woday Tadesse ◽  
Muluken Dessalegn ◽  
Setognal Birara ◽  
Kusse Urmale ◽  
Gebeyaw Biset ◽  
...  

Abstract Background: Birth asphyxia among preterm babies accounted for nearly fifty percent of neonatal mortality in sub-Saharan African countries. This scenario has been worst in Ethiopia where every two out of three deaths attributed to birth asphyxia. Moreover, studies conducted in Ethiopia lack consistency in the prevalence and risk factors of birth asphyxia. Objective: This study aims to analyses collectively and systematically prevalence of birth asphyxia and associated factors among preterm neonates in Ethiopia. Methods: The protocol for this review is registered at PROSPERO with registration number CRD42020158224. 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 will be searched until June 30, 2020. The quality of studies will be assessed using Joanna Briggs Institute (JBI) checklist. Three reviewers will screen all retrieved articles, conduct data extraction, and then critically appraise all identified studies. All identified observational studies reporting the prevalence of birth asphyxia and associated factors among neonates in Ethiopia will be considered. The analysis of data will be done using STATA 14.0 statistical software. We will demonstrate pooled estimates and determinants of neonatal mortality 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 to invest limited resources on maternal and neonatal health. Furthermore, it will be a stimulus for future cumulative meta-analysis researchers in developing nations.

2020 ◽  
Author(s):  
Abay Woday ◽  
Muluken Dessalegn ◽  
Setognal Birara ◽  
Kusse Urmale ◽  
Gebeyaw Biset ◽  
...  

Abstract Background: Birth asphyxia among newborns accounted for nearly fifty percent of neonatal mortality in sub-Saharan African countries. This scenario has been worst in Ethiopia where every two out of three deaths attributed to birth asphyxia among these babies. Moreover, studies conducted in Ethiopia are highly variable and inconclusive to estimate the pooled prevalence and risk factors of birth asphyxia. Objective: This study aims to analyses collectively and systematically the prevalence of birth asphyxia and associated factors among newborns in Ethiopia.Methods: The protocol for this review is registered at PROSPERO with registration number CRD42020158224. A comprehensive online databases (PubMed, HINARI, Scopus, EMBASE, Science direct, and Cochrane library database), Google Scholar, African Journals online, other gray and online repository accessed studies will be searched using different search engines. In addition, maternity & infant care databases uploaded at Ethiopian Health Development Journal and Ethiopian Journal of Health Sciences will be searched until June 30, 2020. Newcastle-Ottawa Quality Assessment Scale (NOS) will be used for critical appraisal of studies.. Three reviewers will screen all retrieved articles, conduct data extraction, and then critically appraise all identified studies. All identified observational studies reporting the prevalence of birth asphyxia and associated factors among neonates in Ethiopia will be considered. The analysis of data will be done using STATA 11.0 statistical software. We will demonstrate pooled estimates and determinants of birth asphyxia with effect size and 95% confidence interval. Heterogeneity among the included studies will be assessed through the Cochrane Q-test statistics and I2 test. Publication bias will be checked using funnel plot and egger’s test. Finally, statistical significance level will be declared at a p-value of less than 0.05. Discussion: the result from this systematic review will inform and guide health policy planners to invest limited resources on maternal and neonatal health. Furthermore, it will be a stimulus for future cumulative meta-analysis researchers in developing nations.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255488
Author(s):  
Ritbano Ahmed ◽  
Hassen Mosa ◽  
Mohammed Sultan ◽  
Shamill Eanga Helill ◽  
Biruk Assefa ◽  
...  

Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).


2020 ◽  
Author(s):  
Abay Woday ◽  
Mulluken Dessalegn ◽  
Setognal Birara ◽  
Kusse Urmale

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.


2017 ◽  
Vol 157 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Hyun Jin Min ◽  
Hyun Kang ◽  
Geun Joo Choi ◽  
Kyung Soo Kim

Objective Whether there is an association or a cause-and-effect relationship between epistaxis and hypertension is a subject of longstanding controversy. The objective of this systematic review and meta-analysis was to determine the association between epistaxis and hypertension and to verify whether hypertension is an independent risk factor of epistaxis. Data Sources A comprehensive search was performed using the MEDLINE, EMBASE, and Cochrane Library databases. Review Methods The review was performed according to the Meta-analysis of Observational Studies in Epidemiology guidelines and reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Results We screened 2768 unique studies and selected 10 for this meta-analysis. Overall, the risk of epistaxis was significantly increased for patients with hypertension (odds ratio, 1.532 [95% confidence interval (CI), 1.181-1.986]; number needed to treat, 14.9 [95% CI, 12.3-19.0]). Results of the Q test and I2 statistics suggested considerable heterogeneity ([Formula: see text] = 0.038, I2 = 49.3%). The sensitivity analysis was performed by excluding 1 study at a time, and it revealed no change in statistical significance. Conclusion Although this meta-analysis had some limitations, our study demonstrated that hypertension was significantly associated with the risk of epistaxis. However, since this association does not support a causal relationship between hypertension and epistaxis, further clinical trials with large patient populations will be required to determine the impact of hypertension on epistaxis.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alemu Degu Ayele ◽  
Habtamu Gebrehana Belay ◽  
Bekalu Getnet Kassa ◽  
Mulugeta Dile Worke

Abstract Background Preconception care is the provision of biomedical, behavioural, and social health interventions provided to women and couples before conception. However, in Ethiopia, little is known and practised to support preconception care. Therefore, this study aimed to assess women’s knowledge and utilisation of preconception care and its associated factors in Ethiopia using systematic review and meta-analysis. Method In the current meta-analysis, variables were searched from different electronic database systems, which included PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were analysed by using STATA 14 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled knowledge and utilisation of preconception care. Results Thirteen full-text studies were included. The pooled prevalence of knowledge and utilisation of preconception care among women in Ethiopia was 30.95% and 16.27% respectivelly. Secondary education (OR = 2.78, 95% CI,2.01–3.85), college and above (OR = 5.05, 95% CI,2.70–9.44), and antenatal care (OR = 3.89, 95% CI, 1.69–8.98) were significantly associated with knowledge level whereas; age (OR = 2.43, 95% CI, 1.30–4.53) and knowledge on preconception care (OR = 3.95, 95% CI,2.35–6.62) were positively associated with utilisation of preconception. Conclusions Women’s level of knowledge and utilisation of preconception care was significantly low. Educational status and antenatal care follow-up were factors shown to affect knowledge of preconception care. Age and having a sound knowledge of preconception care indicated a significant association towards utilisation of preconception care. Thus, integrating preconception care strategies and policies that can address all the components of preconception care services with other maternal and child health services will be essential when designing effective implementation strategies to improve preconception care uptake. Besides this, advocating for better education for women, awareness creation, and increasing antenatal care services are essential. Prospero registration: CRD42020218062


Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10683
Author(s):  
Jun Chen ◽  
Lingchun Lyu ◽  
Jiayi Shen ◽  
Chunlai Zeng ◽  
Cheng Chen ◽  
...  

Objective Our study aimed to assess the risk of all fractures and hip fractures in patients with atrial fibrillation (AF) who took non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin. Methods We searched PubMed, Embase, and Cochrane Library and Clinical Trials.gov Website. Reviewed related researches up to January 31, 2020, to identify studies with more than 12 months of follow-up data. The protocol for this systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO Number: CRD42020156893). Results We included five RCT studies, and five observational studies that contained a total of 326,846 patients in our meta-analysis. Our meta-analysis showed that patients taken NOACs had no significant all fracture risk (RR = 0.91, 95% CI [0.81–1.01]) and hip fracture risk (RR = 0.92, 95% CI [0.82–1.03]) compared with those taken warfarin. Subanalysis showed that the risk of all fractures and hip fractures treated by NOACs were significant lower compared with warfarin in observational studies compared with RCT studies. Also, a subanalysis across the duration of anticoagulation showed the NOACs users have lower all fracture risk than warfarin users when the duration of anticoagulation ≤2 years (RR = 0.89, 95% CI [0.80–0.99]). Further analysis, significant lower all fracture risk in the rivaroxaban therapy (RR = 0.81; 95% CI [0.76–0.86]) compared with warfarin but no statistical significance in hip fracture. There were no significant difference of all fracture risk and hip fracture risk in dabigatran, apixaban, and edoxaban therapy compared with warfarin. Conclusion The meta-analysis demonstrated that NOACs associated with a significantly lower all fracture risk compared with warfarin when the duration of anticoagulation more than 2 years. Rivaroxaban users had lower risk of all fracture than warfarin users in AF patients. But there was no evidence to verify apixaban, edoxaban, and dabigatranin could decrease all fracture and hip fracture risk compared with warfarin.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040371
Author(s):  
Mengyu Han ◽  
Luqi Nong ◽  
Ziqiang Liu ◽  
You Chen ◽  
Yang Chen ◽  
...  

IntroductionNeuromyelitis optica spectrum disorders (NMOSD) is an inflammatory and heterogeneous astrocyte disorder of the central nervous system with the characteristic of higher incidence in women and Asian people. Most patients with NMOSD have a course of recurrence and remission that is prone to cause paralysis and blindness. Several studies have confirmed the efficacy and promising prospect of mycophenolate mofetil (MMF) in the treatment of NMOSD. Yet its therapeutic effect and safety are controversial. Although there has been two published literature that is relevant to the topic of this study, both of them have certain defects, and they can only provide answers about the efficacy or safety of MMF in the treatment of NMOSD from partial perspectives or conclusions. This research aims to perform a direct and comprehensive systematic review and meta-analysis to evaluate MMF’s effectiveness and safety in treating NMOSD.Methods and analysisThis systematic review will cover all comparative researches, from randomised controlled trials to cohort studies, and case–control study. A relevant literature search will be conducted in PubMed, Web of Science, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and Chinese Biomedical Literature Database from their inception to 31 June 2020. We will also search registers of clinical trials, potential grey literature and abstracts from conferences. There are no limits on language and publication status. The reporting quality and risk of bias will be assessed by two researchers independently. Expanded Disability Status Scales and annualised relapse rate will be evaluated as the primary outcome. The secondary outcomes will consist of the frequency and severity of adverse events, best-corrected visual acuity, relapse-free rate and time to the next attack. A meta-analysis will be performed using RevMan V.5.3 software provided by the Cochrane Collaboration and Stata V.12.0.Ethics and disseminationBecause the data used for this systematic review will be exclusively extracted from published studies, ethical approval and informed consent of patients will not be required. The systematic review will be published in a peer-reviewed journal, presented at conferences and will be shared on social media platforms.PROSPERO registration numberCRD42020164179.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Kochawan Boonyawat ◽  
Pichika Chantrathammachart ◽  
Pawin Numthavaj ◽  
Nithita Nanthatanti ◽  
Sithakom Phusanti ◽  
...  

Abstract Background Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the incidence of thromboembolism has been increasingly reported. The aim of this systematic review was to explore the incidence of venous and arterial thromboembolism among COVID-19 patients requiring hospitalization. Methods Medline, Embase, Scopus, and grey literature were searched until June 2020. Observational studies reported on the incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT) or arterial thromboembolism (ATE) were included. The pool incidences and their 95% confidence intervals (CI) were calculated using the random-effects model. Results A total of 36 studies were included. In the intensive care unit (ICU) setting, the pooled incidence of VTE was 28% (95% CI, 22–34%). Subgroups based on compression ultrasound (CUS) screening revealed a higher incidence of DVT in the CUS screening group than in the no CUS screening group (32% [95% CI, 18–45%] vs. 6% [95% CI, 4–9%]). The pooled incidence of ATE in ICU was 3% (95% CI, 2–5%). In the non-ICU setting, the pooled incidence of VTE was 10% (95% CI, 6–14%,). Conclusions The incidence of VTE in COVID-19 patients was higher in the ICU setting than in the non-ICU setting, and also significantly higher in studies that incorporated the CUS screening protocol. The incidence of ATE in the ICU setting was low. VTE prophylactic measures should be given to all hospitalized patients diagnosed with COVID-19.


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