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

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.

2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Moges Mareg ◽  
Esmelealem Mihretu

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.


Author(s):  
Alemu Earsido Addila ◽  
Telake Azale Bisetegn ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal Mengistu ◽  
Getnet Mihretie Beyene

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.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.


PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222566 ◽  
Author(s):  
Tesfalidet Tekelab ◽  
Catherine Chojenta ◽  
Roger Smith ◽  
Deborah Loxton

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Siraj Hussen ◽  
Birkneh Tilahun Tadesse

Objective. Syphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women. Design. Systematic review and meta-analysis. Data Sources. Databases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women. Data Extraction. Our search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included. Results. The pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period. Conclusion. This review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.


2020 ◽  
Author(s):  
Bekahegn Girma ◽  
Jemberu Nigussie ◽  
Alemayehu Molla ◽  
Moges Mareg

Abstract AbstractBackground: Under nutrition is a global problem and in increasing trend in recent years. The burden is high in low and middle-income countries; especially in Africa. Lactating women are among the most vulnerable groups for undernutrition; especially in sub-Saharan Africa. However, the prevalence of undernutrition among this group is inconsistent and inconclusive in Ethiopia, and also the national nutritional plan of 2015 is not yet achieved. Furthermore, to achieve the 2030 Sustainable developmental plan, conducting this type of summarized reviews are helpful. Therefore, we aimed to assess the pooled prevalence of undernutrition and its associated factors among lactating mothers in Ethiopia.Methods: To write this review and meta-analysis we followed the preferred reporting items for systematic reviews and meta-analysis guidelines. We used PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar for searching. STATA version 14 software and a standardized format were used for analysis and data extraction respectively. Heterogeneity was checked using I2. A random-effect meta-analysis model was used to determine the pooled prevalence of undernutrition. Begg's and Egger's tests were conducted to detect publication bias. Subgroup analysis was also conducted and association was expressed by a pooled odds ratio with 95% CI.Result: A total of 16 studies were included with a total of 7830 Ethiopian lactating women. The pooled prevalence of undernutrition among lactating mothers was found to be 23.86% (95% CI: 19.01, 28.72). The result of heterogeneity test was I2 = 96.7% and p < 0.001). The Begg's and Eger's test findings after we removed two influential primary articles were P: 0.443 and P: 0.306 respectively. Educational status (no formal education) (Pooled OR: 2.30 (95% CI: 1.34, 3.96)) was significantly associated with undernutrition.Conclusion: The pooled prevalence of undernutrition was high. Maternal educational status was significantly associated with undernutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups, refine their strategies to address this issue, and strengthen the implementation of the previously designed strategies.


2021 ◽  
Vol 4 ◽  
pp. 100080
Author(s):  
Haile Amha ◽  
Henok Mulugeta ◽  
Asmamaw Getnet ◽  
Dessalegn Haile ◽  
Keralem Anteneh ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Teferi Teklu ◽  
Nitin Mahendra Chauhan ◽  
Firaol Lemessa ◽  
Getu Teshome

Sub-Saharan Africa remains to be the most heavily affected region by malnutrition, accounting for 23.8% share of the global burden. Undernutrition weakens the immune system, increases the susceptibility to infections, and may worsen the impact on various kinds of diseases. Our aim was to assess undernutrition and its associated factors among AIDS-infected adult patients from Asella, Oromia Region, Ethiopia. An institutional-based cross-sectional study design was employed from June to July 2018. A total number of 519 patients were selected for the proposed work. Data was entered into EpiData, checked, coded, and analyzed using SPSS version 21 software. Descriptive statistics were used to assess the prevalence of undernutrition among patients. Bivariate and multivariate regressions were used to determine the relationship between undernutrition and its associated factors among the study participants. The results of our study showed that the overall prevalence of undernutrition was 18.3%; out of which 12.7% were mildly and 5.6% were moderately to severely undernourished, respectively. Monthly income (AOR: 3.589, 95% CI (1.469-8.768)), whole grain feeding (AOR: 2.979, 95% CI (1.252-7.088)), opportunistic infections in the last six months (AOR: 3.683, 95% CI (3.075-4.411)), clinical stage (AOR: 2.998, 95% CI (1.269-7.083)), and insufficient quality of food (AOR: 3.149, 95% CI (1.339-7.406)) were found to be significantly associated with undernutrition in this study. Therefore, HIV treatment facility should be supported with nutritional assessment, supplementation, counseling, care, and support to patients that may possibly alleviate this predicament.


2021 ◽  
Author(s):  
Etsay Woldu Anbesu ◽  
Setognal Birara Aychiluhm

Abstract Background: Poor menstrual hygiene practices can lead to gynecological problems, psychosocial stress, and reduced access to school. Menstrual hygiene has not received adequate attention in Sub-Saharan Africa. Moreover, there were fragmented and inconsistent findings. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of menstrual hygiene practice and identify its associated factors among adolescent girls in Sub-Saharan Africa.Methods: The protocol for this review had registered at PROSPERO with registration number: CRD42020165628. In this study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be used. Online electronic databases PubMed, Google Scholar, CINAHL and grey literature will be searched to retrieve available studies. Joanna Briggs Institute checklist will be used to assess the quality of the studies. Heterogeneity among studies will be examined using a chi-squared test and I-squared statistic.To investigate sources of heterogeneity, subgroup analyses and meta-regression will be performed. Sensitivity analysis will be conducted to identify influential studies. Publication bias will be examined by funnel plots and Egger’s test. The statistical analysis will be conducted using STATA version-16 software. A random-effect model will be used to estimate the pooled prevalence, and statistical significance will be determined at a p-value of <0.05.Discussion: Poor menstrual hygiene practice affects the health of millions of adolescent girls in developing countries. Currently, there are no synthesis research findings on the overall pooled prevalence of menstrual hygiene practice and its associated factor in Sub-Saharan Africa. Therefore, this systematic review and meta-analysis will be used to inform policy-makers, programmers, planners, clinicians, and researchers to design appropriate strategies.


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