scholarly journals Magnitude of Postpartum Hemorrhage and Its Associated Factors in Ethiopia: Systematic Review and Meta-analysis.

Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Takila Tamir ◽  
Rute Tilahun

Abstract Background: Postpartum hemorrhage or postpartum bleeding (PPH) is often defined as loss of > 500 ml of blood after vaginal delivery or > 1,000 ml after cesarean delivery within 24 hrs. Postpartum hemorrhage is a leading direct cause of maternal morbidity and mortality in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis was to estimate the pooled magnitude of postpartum hemorrhage and the pooled effect size of the associated factors in Ethiopia.Methods: Primary studies were searched in PubMed / MEDLINE online, Science Direct and Hinari Cochrane Library, CINAHL, African Journals Online databases, Google and Google Scholars. The search for studies was not limited by time and all articles up to October 10/2021 were included. The data extraction format was prepared in Microsoft Excel. The data extracted from the Microsoft Excel format was exported to Stata Version 16.0 statistical software for analysis. A random effect meta-analysis model was used. Statistical heterogeneity was evaluated by the I2 test and Egger's weighted regression test was used to assess publication bias.Result: A total of 165 records from the electronic databases were excluded, but 145 records were excluded for different reasons, and finally 20 studies were included in this final analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 8.18% [(95% CI; 6.996 - 9.363]. Older age [OR= 5.038 (95% CI; 2.774 - 9.151)], prolonged labor [OR = 4.054 (95% CI; 1.484 - 11.074)], absence of ANC visit [OR = 13.84 (95% CI; 5.57 - 34.346)] grand-multiparty, [OR = 6.584 (95% CI; 1.902 - 22.795)], and history of postpartum hemorrhage [OR = 4.355 (95% CI; 2.347 - 8.079)] were identified as factors for the occurrence of postpartum hemorrhage.Conclusions: This study concludes that the magnitude of postpartum hemorrhage in Ethiopia was moderately high. The finding was strongly help different stakeholder working in maternal and child health to focus on the main contributors factors to reduce PPH. Health professionals attending delivery should emphasize high-risk groups of mothers. Encouraging ANC visit and prevent prolonged labor should be recommended to reduce the occurrence of postpartum hemorrhage.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alemu Gebrie ◽  
Animut Alebel ◽  
Abriham Zegeye ◽  
Bekele Tesfaye ◽  
Fasil Wagnew

Abstract Background Trachoma is the commonest infectious cause of blindness. It is prevalent in areas where personal and community hygiene is poor, and it mainly affects deprived and marginalized communities most importantly in Ethiopia. Hence, the aim of this study was to determine the prevalence and associated factors of active trachoma among children in Ethiopia. Method A systematic review and meta-analysis was employed to determine the prevalence of active trachoma and associated factors among children in Ethiopia. We searched databases, including PubMed, Google Scholar, Science Direct, EMBASE and Cochrane Library. To estimate the prevalence, studies reporting the prevalence of active trachoma and its associated factors were included. Data were extracted using a standardized data extraction format prepared in Microsoft excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistics and I2 test were used. Since the included studies revealed considerable heterogeneity, a random effect meta- analysis model was used to estimate the pooled prevalence of active trachoma. Moreover, the association between factors and active trachoma were examined. Results The result of 30 eligible studies showed that the overall prevalence of active trachoma among children in Ethiopia was 26.9% (95% CI: 22.7, 31.0%). In the subgroup analysis, while the highest prevalence was reported in SNNP (35.8%; 95% CI: 22.7, 48.8), the lowest prevalence was reported in Oromia region (20.2%; 95% CI: 12.2, 28.2). Absence of latrine: OR 6.0 (95% CI 2.0, 17.5), the unclean faces of children: OR 5.5 (95% CI 2.8, 10.9), and no reported use of soap for washing: OR 3.3 (95% CI 1.8, 6.0) have shown a positive association with active trachoma among children. Conclusion From this review, it has been concluded that active trachoma among children is still a public health problem in different districts of Ethiopia. The prevalence of almost all studies are significantly higher than WHO target for elimination. Absence of latrine, unclean faces of children, no reported use of soap for washing are the important factors associated with active trachoma among children.


Author(s):  
Arkaitz Castañeda-Babarro ◽  
Diego Marqués-Jiménez ◽  
Julio Calleja-González ◽  
Aitor Viribay ◽  
Patxi León-Guereño ◽  
...  

Background: There are many athletes who like to listen to music while making a high intensity effort. However, research into the effects of listening to music on athletic performance has provided controversial results, and it is suggested that the timing and type of music might affect the anaerobic performance response. Purpose: The main aim of the current systematic review and meta-analysis was to analyze the effects while listening to music tasks via the 30 s Wingate anaerobic test (WAnT) on absolute performance and relative peak power (APP and RPP), absolute and relative mean power (AMP and RMP), and fatigue index (FI). Methods: PRISMA guidelines were used as a basis for conducting this systematic review, with inclusion criteria being set out according to the PICOS model. Computer-based literature research was undertaken until 10 March 2020 using the following online databases: PubMed/Medline, WOS, Cochrane Library, and Scopus. The literature was reviewed with regard to the effects of listening to music on the WAnT using several music variables on: APP, RPP, AMP, RMP and FI. Hedges’ g formula was used to calculate both standard mean differences and 95% confidence intervals, in order to establish continuous outcomes. Furthermore, the I2 statistic evaluated systematic differences (heterogeneity) together with a random effect meta-analysis model. Results: This systematic review included nine articles that researched into the effects of music on WAnT performance (six studies describe improvements in APP and/or RPP, four in AMP and/or RMP and three in FI). The random effects model was used to undertake a final meta-analysis, with standardized mean differences (SMD) and magnitude of standardized mean differences (MSMD) (Hedges’ g) being pooled accordingly. The resulting meta-analysis incorporated eight studies that had been previously published, with results showing that there were no apparent beneficial effects on APP (p = 0.09), AMP (p = 0.33) and FI (p = 0.46) as a consequence of listening to music. However, listening to music showed beneficial effects on RPP (SMD: 0.65; 95%: CI 0.35 to 0.96; MSMD: moderate; I2, 0%; p < 0.001) and RMP (SMD: 1.03; 95%: CI, 0.63 to 1.42; MSMD: trivial; I2, 0%; p < 0.001). Conclusion: This systematic review and meta-analysis has shown that listening to music during the WAnT might physiologically enhance relative anaerobic exercise performance, although reasons remain speculative.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohammed Oumer ◽  
Anteneh Ayelign Kibret ◽  
Amanuel Girma ◽  
Ashenafi Tazebew ◽  
Mezgebu Silamsaw

AbstractAnencephaly is a severe anomaly of the brain that results from the failure of the cephalic part of the neural tube to close during the fourth week. It occurs at least in one per thousand births and is the major cause of fetal loss and disabilities in newborns. The objective of this review is to determine the birth prevalence of anencephaly in Africa. We identified relevant studies via a search of databases like PubMed Central, PubMed/Medline, Science Direct, Joanna Briggs Institute, African Journals Online, Embase, Google Scholar, Web of Science, and Cochrane Library. After examining the heterogeneity of studies via the Cochran Q test and I2 test (and Forest plot for visual inspection), the prevalence of anencephaly was estimated using the random-effect meta-analysis model. Consequently, we carried out subgroup, sensitivity, meta-regression, trim and fill, time-trend, and meta-cumulative analyses. In this systematic review and meta-analysis, the twenty-four studies reported a total of 4,963,266 births. The pooled birth prevalence of anencephaly in Africa was 0.14% (95% CI: 0.12, 0.15%). Higher burden of anencephaly was detected in Ethiopia (0.37%, CI: 0.15, 0.58%), Algeria (0.24%, CI: 0.24, 0.25%), and Eritrea (0.19%, CI: 0.19, 0.19%). The higher pooled prevalence of anencephaly was observed in the studies that included both live births and stillbirths (0.16%) and in studies done after the year 2010 (0.25%) whereas, the lower burden was detected among countries that had a mandatory folic acid fortification (0.05%). High birth prevalence of anencephaly was detected in Africa. Strong prevention and control measures should be the priority because of an increment in the magnitude of anencephaly. Helping in prevention programs, which should be the ultimate contribution of this study to the field.


2020 ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Nigussie ◽  
Biruk Zewdu

Abstract BackgroundGlobally, maternal morbidity and mortality remained a major public health challenge. Delivering at home is associated with a higher risk of maternal deaths. Findings on the prevalence and associated factors of home delivery are highly variable and inconsistent across Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of home delivery and its associated factors in Ethiopia.MethodPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases used were; PubMed, Google Scholar, Cochrane Library, African Journals Online, Ethiopian's university research repository online library, and manual searching. The search was further limited to studies conducted in Ethiopia and reported in English. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity of studies. The pooled estimate prevalence and the odds ratios with 95% confidence intervals were computed by a random effect model.ResultA total of 13 studies were included in this meta-analysis with a sample size of 13,535. The national pooled prevalence of home delivery was 48.53 % (95% CI:35, 62). The pooled adjusted odds ratio (AOR) of home delivery for Place of rural residence was 4.3(AOR = 4.3; 95% CI 2.7, 6.8), husband preference was 5(AOR=5.1 95%CI:1.1, 22), not having ANC follows up was 3.3(AOR= 3.3,95%CI:2,6), Women who cannot read & write was 4(AOR=4.36,95% CI:3.1, 6.12), Primary level was 4(AOR=4.21, 95%CI:1.5, 11.6) ,and secondary & above was 1.9(AOR=1.9,95%CI:1.1, 3.45), distance from the health facility was 7(AOR= 7.33, 95%CI:5.75, 9.35), age of mothers 15-24 was 4(AOR =3.7,95%CI:2, 6.6), knowledge of danger sign of pregnancy was 4(AOR=4.60 95%CI:3, 6.8), and no media access was 3.4(AOR=3.495%CI: 1.5, 7.5).ConclusionThis systematic review and meta-analysis showed that home delivery was high in Ethiopia. Place of residence, husband preference, no having ANC follows up, educational status of mothers, distance from health facility, age of mothers, knowledge of danger sign of pregnancy, and no media access increased the risk of home delivery.


2021 ◽  
Vol 5 (1) ◽  
pp. e001117
Author(s):  
Mohammed Oumer ◽  
Alemnew Demissie Kassahun

ObjectiveTo identify the birth prevalence of encephalocele in Africa, 2020.MethodsWe carried out a systematic search of the following databases (PubMed/Medline, PubMed Central, Joanna Briggs Institute (JBI) Library, Cochrane Library, Web of Science, Google Scholar, Science Direct, African Journals Online and Embase), using search terms (prevalence, encephalocele, “neural tube defects”, “cranium bifidum”, “congenital malformations”, “congenital defects”, “structural birth defects”, “structural abnormalities”, newborns/neonates/ “live births”/ “stillbirths” and their MeSH Terms) up to 16 July 2021. The JBI quality appraisal checklist was used to assess the quality of studies when they were abstracted using a standardised data extraction template. The I2 statistic and Cochrane Q test were used to examine heterogeneity across studies statistically. The prevalence of encephalocele was estimated using a random-effect meta-analysis model. Subgroup, sensitivity, meta-regression and time trend analysis were carried out. The publication bias was checked using Egger and Begg’s tests.ResultsTwenty-seven relevant studies were identified and provided a total of 5 107 109 births. In this systematic review and meta-analysis, the pooled birth prevalence of encephalocele in Africa was 0.02% (or 2 per 10 000 births) (95% CI 0.02% to 0.03%). The overall prevalence of birth encephalocele using the median from studies was 0.02% (IQR=0.01%–0.04%). Higher prevalence of encephalocele was detected in Nigeria 0.06% (95% CI 0.04% to 0.08%), Sudan 0.04% (95% CI 0.03% to 0.05%), Egypt 0.04% (95% CI 0.04% to 0.05%), DR of Congo 0.02% (95% CI 0.02% to 0.03%), Ethiopia 0.02% (95% CI −0.004% to 0.05%) and Tanzania 0.02% (95% CI 0.002% to 0.04%). The prevalence of encephalocele per live birth was 0.03% and both live birth and stillbirth was 0.03%.ConclusionsThis review indicates a high prevalence of encephalocele, but studies were limited suggesting the need for additional research.PROSPERO registration numberCRD42021242161.


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

Abstract Background: Colostrum is the first milk produced by the mammary glands during the second half of pregnancy for a few days (3-4) after birth. However, colostrum is a normative standard for infants’ complete form of nutrition, most mothers' giving prelacteal food such as honey, butter, sugar water, and plain water instead of colostrum to their newborn. In Ethiopia, colostrum was seen as abnormal milk causing abdominal problems, and to mitigate this problem most mothers were discarding the portion of the colostrum. Although studies have been conducted on colostrum avoidance and associated factors in Ethiopia, their report was inconsistent regarding the prevalence and associated factors. The main aim of this systematic review and meta-analysis was to estimate the pooled prevalence of colostrum avoidance and associated factors in Ethiopia.Methods: In this systematic review and meta-analysis databases such as Google, Google Scholar, PubMed/Medline, Science Direct, and Hinari were searched. We found a total of 327 records, of which 292 records were excluded due to duplication and unrelated to our objective. Finally, 35 studies were included in this systematic review and meta-analysis. The data were extracted in Microsoft Excel format and exported to STATA Version 14.0 statistical software for analysis. Heterogeneity was checked by the I2 test. A random-effect meta-analysis model was used to estimate the pooled prevalence of colostrum avoidance and associated factors. Egger’s weighted regression and Begg’s rank correlation test were used to assess publication bias. Result: This review revealed that the pooled prevalence of colostrum avoidance in Ethiopia was 20.5% (95% CI; 16.46, 24.45). Ante-natal care (ANC) visits [OR= 0.274 (95% CI; 0.175, 0.428)], place of delivery [OR= 3.8 (95% CI; 2.9, 4.9)], breastfed counselling [OR= 0.261(95% CI; 0.147 - 0.462), timely initiation of breast feeding [OR = 3.8 (95% CI; 1.9, 7.4)] and prelacteal feeding [OR= 5.77 (95% CI; 4.03- 8.22)] were significant factors for colostrum avoidance. Conclusion: This meta-analysis showed that one of five mothers discarded colostrum in Ethiopia. Colostrum avoidance was higher in rural mothers than in urban mothers. Strengthening ANC visits, institutional delivery, breastfed counseling, early initiation of breastfeeding, and avoidance of prelacteal feeding are recommended interventions to reduce colostrum avoidance in Ethiopia. Furthermore, promoting the health benefit of colostrum and its nutritional value also emphasizes to improving colostrum feeding in the community.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21692-e21692
Author(s):  
Rohit Kumar ◽  
Naina Singh ◽  
Romy Jose Thekkekara ◽  
Sunny R K Singh ◽  
Sarah Elizabeth Harrington ◽  
...  

e21692 Background: Olanzapine is an atypical antipsychotic medication which has shown efficacy in prevention of chemotherapy-induced nausea and vomiting (CINV) in multiple trials. This study aims to investigate the efficacy of Olanzapine to prevent CINV with an up-to-date systematic review and meta-analysis. Methods: A literature search of Ovid MEDLINE, Embase and Cochrane library was performed to identify randomized controlled trials of olanzapine compared to other antiemetic therapy (5HT3 and/or NK1 antagonist with or without steroids) for prevention of CINV in patients age >=18 years up until December 2016. The primary endpoint was no emesis or nausea episodes in acute (0-24hrs), delayed (24-120hrs) and overall (0-120hrs) period in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC). Statistical analysis was performed using Review Manager (RevMan 5.3). The Mantel–Haenszel method was applied and random effect analysis model was used to calculate risk ratios. Results: From the literature, 12 RCTs met the inclusion criteria. The age range of patients was 18-89 years. Seven trials included only patients who received HEC while 5 trials included patients receiving either HEC or MEC in various proportions. Olanzapine was statistically superior for 5 primary endpoints except for no nausea in acute period (Table 1). In the non-steroids cohort, olanzapine was superior for no emesis in all 3 periods but statistically significant only for delayed period. Conclusions: Olanzapine is superior to other antiemetic therapy for prevention of CINV. It is less expensive and can improve patient’s quality of life and chemotherapy adherence. [Table: see text]


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.


2021 ◽  
Vol 11 ◽  
Author(s):  
Jiale Sun ◽  
Yuxin Lin ◽  
Xuedong Wei ◽  
Jun Ouyang ◽  
Yuhua Huang ◽  
...  

Background: Prostate-specific membrane antigen (PSMA)-targeted 2-(3-{1-carboxy-5-[(6-[18F] fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) positron emission tomography/computed tomography (PET/CT) has shown advantages in primary staging, restaging, and metastasis detection of prostate cancer (PCa). However, little is known about the role of 18F-DCFPyL PET/CT in biochemically recurrent prostate cancer (BRPCa). Hence, we performed a systematic review and meta-analysis to evaluate 18F-DCFPyL PET/CT as first-line imaging modality in early detection of BRPCa.Methods: A comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane Library was conducted until December 2020. The pooled detection rate on a per-person basis and together with 95% confidence interval (CI) was calculated. Furthermore, a prostate-specific antigen (PSA)-stratified performance of detection positivity was obtained to assess the sensitivity of 18F-DCFPyL PET/CT in BRPCa with different PSA levels.Results: A total of nine eligible studies (844 patients) were included in this meta-analysis. The pooled detection rate (DR) of 18F-DCFPyL PET/CT in BRPCa was 81% (95% CI: 76.9–85.1%). The pooled DR was 88.8% for PSA ≥ 0.5 ng/ml (95% CI: 86.2–91.3%) and 47.2% for PSA &lt; 0.5 ng/ml (95% CI: 32.6–61.8%). We also noticed that the regional lymph node was the most common site with local recurrence compared with other sites (45.8%, 95% CI: 42.1–49.6%). Statistical heterogeneity and publication bias were found.Conclusion: The results suggest that 18F-DCFPyL PET/CT has a relatively high detection rate in BRPCa. The results also indicate that imaging with 18F-DCFPyL may exhibit improved sensitivity in BRPCa with increased PSA levels. Considering the publication bias, further large-scale multicenter studies are warranted for validation.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Celestin Danwang ◽  
Jean Joel Bigna

Abstract Background Gastric cancer is actually known as the sixth most frequent cancer and the second cancer-related cause of death worldwide. If studies giving an overview of current epidemiology of gastric cancer in Europe, Asia, and the USA are available, in Africa, studies reporting recent data on gastric cancer are sparse. This systematic review and meta-analysis aim therefore to provide relevant data on contemporary epidemiology of gastric cancer in Africa in terms of prevalence, incidence, and case fatality rate. Methods and design We will include cohort, case-control, cross-sectional studies, and case series with more than 30 participants. EMBASE, PubMed, Africa Index Medicus, Africa Journals Online, and Web of Science will be searched for relevant abstracts of studies published and unpublished between January 1, 2000, and April 30, 2019, without language restriction. The review will be reported according to the MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guideline. After screening of abstracts, study selection, data extraction, and risk of bias assessment, we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Egger test and visual inspection of funnel plots will be used to assess publication bias. Discussion This review will provide relevant data on the current burden of gastric cancer in Africa. Systematic review registration PROSPERO CRD42019130348.


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