Prevalence and Risk Factors for Spasticity After Stroke: A Systematic Review and Meta-Analysis

Background: Spasticity is a common sequela of stroke. The incidence of poststroke spasticity (PSS) has not been systematically reviewed in recent years, and some risk factors remain debated. This systematic review and meta-analysis was conducted to determine the prevalence and risk factors for PSS.Methods: We searched electronic databases (PubMed, Embase, Cochrane Library, CNKI, WANFANG and CBM) inception to May 12, 2020. Observational studies summarizing the incidence or risk factors for PSS were included. Only cohort studies were enrolled in meta-analysis. For risk factors examined in at least three different studies, we combined effects into odds ratios (OR) and 95% confidence intervals (CI).Results: One thousand four hundred sixty-seven studies were retrieved and 23 were involved in meta-analysis. The pooled prevalence of spasticity after stroke was 25.3% and that after the first-ever stroke was 26.7%. The incidence of spasticity after the first-ever stroke with paresis was 39.5%. The prevalence of disabling or severe spasticity (MAS ≥ 3) in stroke patients with paresis was 9.4% (95% CI 0.056–0.133), and severe spasticity was 10.3% (95% CI 0.058–0.149). Moderate to severe paresis (OR = 6.573, 95% CI 2.579–16.755, I2 = 0.0%), hemorrhagic stroke (OR = 1.879, 95% CI 1.418–2.490, I2 = 27.3%) and sensory disorder were risk factors for PSS.Conclusions: The incidence of PSS was significantly higher in stroke patients with paresis. Patients with moderate to severe paresis and sensory disorder should be closely followed up. The role of hemorrhagic stroke in predicting PSS remains to be further explored.

Download Full-text

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0255488 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255488

Author(s):

Ritbano Ahmed ◽

Hassen Mosa ◽

Mohammed Sultan ◽

Shamill Eanga Helill ◽

Biruk Assefa ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Birth Asphyxia ◽

Public Health Problem ◽

Cochrane Library ◽

Chronic Hypertension ◽

Factors Associated ◽

Pooled Prevalence

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).

Download Full-text

Prevalence of Metabolic Syndrome among Children and Adolescents in High-Income Countries: A Systematic Review and Meta-Analysis of Observational Studies

BioMed Research International ◽

10.1155/2021/6661457 ◽

2021 ◽

Vol 2021 ◽

pp. 1-24

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Zelalem Tenaw ◽

Animut Alebel ◽

Teshager Worku ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Children And Adolescents ◽

Observational Studies ◽

Meta Analysis ◽

High Income ◽

Pooled Prevalence ◽

Obese Population

Introduction. Metabolic syndrome (MetS) is an assemblage of interconnected cardiovascular risk factors that are prevalent among children and adolescents in high-income countries (HICs). Despite the presence of several studies on the issue, the study findings are incongruent due to the absence of a gold standard diagnostic method of MetS in children. Thus, the findings of the original studies are inconclusive for policy makers and other stakeholders. This systematic review and meta-analysis is aimed at giving conclusive evidence about MetS among children and adolescents in HICs. Methods. We conducted searches using electronic databases (PubMed, Scopus, Web of Science, CINAHL (EBSCOhost), EMBASE (Elsevier), and Medline (EBSCOhost)) and other sources (Google Scholar and Google) up to September 2020. Observational studies reporting the prevalence of MetS were eligible in this study. The pooled estimates were computed in fixed and random effect models using six diagnostic methods (IDF, ATP III, de Ferranti et al., WHO, Weiss et al., and Cruz and Goran). Publication bias was verified using funnel plots and Egger’s regression tests. Subgroup and sensitivity analysis were performed in case of higher heterogeneities among the included studies. Result. In this study, 77 studies with a total population of 125,445 children and adolescents were used in the final analysis. Metabolic syndrome among the overweight and obese population was computed from 28 studies with the pooled prevalence of 25.25%, 24.47%, 39.41%, 29.52%, and 33.36% in IDF, ATP III, de Ferranti et al., WHO, and Weiss et al. criteria, respectively. Likewise, 49 studies were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, MetS was found in 3.70% (IDF), 5.40% (ATP III), 14.78% (de Ferranti et al.), 3.90% (WHO), and, 4.66% (Cruz and Goran) of study participants. Regarding the components of MetS, abdominal obesity in the overweight and obese population, and low HDL-C in the general population were the most common components. Besides, the prevalence of Mets among males was higher than females. Conclusion. This study demonstrates that MetS among children and adolescents is undoubtedly high in HICs. The prevalence of MetS is higher among males than females. Community-based social and behavioral change communications need to be designed to promote healthy eating behaviors and physical activities. Prospective cohort studies could also help to explore all possible risk factors of MetS and to design specific interventions accordingly.

Download Full-text

Burden of Asymptomatic Bacteriuria Amongst Nigerian Pregnant Women: A Protocol for Systematic Review and Meta-Analysis

10.21203/rs.3.rs-148324/v1 ◽

2021 ◽

Author(s):

Daniel N Onwusulu ◽

Helen Chioma Okoye ◽

Emmanuel O Nna ◽

Samuel Onuka ◽

Amaka Obiageli Nnamani ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Asymptomatic Bacteriuria ◽

Cochrane Library ◽

Categorical Variables ◽

Pooled Prevalence ◽

Associated Risk Factors

Abstract BackgroundAsymptomatic bacteriuria can be a cause of adverse pregnancy and neonatal outcomes if undetected and untreated. Pregnant women are usually routinely screened with urine cultures at antenatal booking. However, the exact burden of asymptomatic bacteriuria in Nigeria is unknown. Our protocol is aimed at determining the pooled prevalence of asymptomatic bacteriuria amongst Nigerian pregnant women as well as the associated risk factors and pregnancy outcomes.MethodsNine databases: PubMed, African Journal Online, Google Scholar, Cochrane Library, CINAHL, Embase, ResearchGate, Scopus, and Web of Science will be searched using a search strategy that is developed by combinations of MeSH terms, keywords, text words, and entry terms. Only observational studies published or retrievable in the English Language will be included. Studies must be conducted in Nigeria. The primary measurable outcome of this study is the prevalence of asymptomatic bacteriuria in pregnant women. Identified studies will be screened, selected, and deduplicated in DistillerSR. Data items will be extracted into predefined forms in the DistillerSR. Reports including Prisma flow chart, quality scores, risk of bias, and study outcomes will be generated in DistillerSR. Extracted data items will be exported into the Comprehensive Meta-analysis Software version 3 for quantitative analysis. Methodological, clinical, and statistical heterogeneity will be assessed for all the studies. Publication bias will be assessed using Funnel plots. There will be a subgroup analysis of pooled prevalence using categorical variables. The primary outcome will be expressed in pooled prevalence, standard error, variance, and 95% CI of variance. Quantitative risk factors and pregnancy outcomes will be used used for meta-regression. The reporting of the systematic review and meta-analysis will be according to PRISMA 2015 Statement.DiscussionThe pooled prevalence of asymptomatic bacteriuria in Nigeria will be examined in relation to associated risk factors and pregnancy outcomes. The study will be published in a peer-reviewed scientific journal.Trial Registration NumberThis protocol is registered with the Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42020213810

Download Full-text

Metabolic risk factors and risk of Covid-19: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0243600 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243600

Author(s):

Bahram Moazzami ◽

Shahla Chaichian ◽

Amir Kasaeian ◽

Shirin Djalalinia ◽

Meisam Akhlaghdoust ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Metabolic Risk Factors ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Metabolic Risk ◽

Services Delivery ◽

Obesity And Diabetes ◽

Pooled Prevalence

Objective Based on the epidemiologic findings of Covid-19 incidence; illness and mortality seem to be associated with metabolic risk factors. This systematic review and meta-analysis aimed to assess the association of metabolic risk factors and risk of Covid-19. Methods This study was designed according to PRISMA guidelines. Two independent researchers searched for the relevant studies using PubMed, Web of Science, Cochrane Library, and Scopus. The search terms developed focusing on two main roots of “Covid-19” and “metabolic risk factors”. All relevant observational, analytical studies, review articles, and a meta-analysis on the adult population were included in this meta-analysis. Meta-analysis was performed using the random effect model for pooling proportions to address heterogeneity among studies. Data were analyzed using STATA package version 11.2, (StataCorp, USA). Results Through a comprehensive systematic search in the targeted databases we found 1124 papers, after running the proses of refining, 13 studies were included in the present meta-analysis. The pooled prevalence of obesity in Covid-19 patients was 29% (95% CI: 14–47%). For Diabetes and Hypertension, these were 22% (95% CI: 12% 33%) and 32% (95% CI: 12% 56%), respectively. There was significant heterogeneity in the estimates of the three pooled prevalence without any significant small-study effects. Such warning points, to some extent, guide physicians and clinicians to better understand the importance of controlling co-morbid risk factors in prioritizing resource allocation and interventions. Conclusion The meta-analysis showed that hypertension is more prevalent than obesity and diabetes in patients with Covid-19 disease. The prevalence of co-morbid metabolic risk factors must be adopted for better management and priority settings of public health vaccination and other required interventions. The results may help to improve services delivery in COVID-19 patients, while helping to develop better policies for prevention and response to COVID-19 and its critical outcomes.

Download Full-text

Prevalence of diabetes and pre-diabetes in Bangladesh: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-036086 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036086

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Aqsa Sarwar ◽

Nida Nasr ◽

Amara Javed ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

General Population ◽

Rural Areas ◽

Urban Areas ◽

Meta Analysis ◽

Cochrane Library ◽

Pooled Prevalence ◽

Significant Difference ◽

Associated Risk Factors

ObjectiveThe purpose of this paper is to perform a systematic review and meta-analysis in order to summarise the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh.DesignSystematic review and meta-analysis.ParticipantsGeneral population of Bangladesh.Data sourcesPubMed, Medline, Embase, Bangladesh Journals Online, Science Direct, Scopus, Cochrane Library and Web of Science were used to search for studies, published between 1st of January 1995 and 31st of August 2019, on the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh. Only articles published in the English language articles were considered. Two authors independently selected studies. The quality of the articles was also assessed.ResultsOut of 996 potentially relevant studies, 26 population-based studies, which together involved a total of 80 775 individuals, were included in the meta-analysis. The pooled prevalence of diabetes in the general population was 7.8% (95% CI: 6.4–9.3). In a sample of 56 452 individuals, the pooled prevalence of pre-diabetes was 10.1% (95% CI: 6.7–14.0; 17 studies). The univariable meta-regression analyses showed that the prevalence of diabetes is associated with the factors: the year of study, age of patients and presence of hypertension. The prevalence of diabetes was significantly higher in urban areas compared with rural areas, while there was no significant gender difference.ConclusionsThis meta-analysis suggests a relatively high prevalence of pre-diabetes and diabetes in Bangladesh, with a significant difference between rural and urban areas. The main factors of diabetes include urbanisation, increasing age, hypertension and time period. Further research is needed to identify strategies for early detecting, prevention and treatment of people with diabetes in the population.PROSPERO registration numberCRD42019148205.

Download Full-text

Long COVID: A Protocol for Systematic Review and Meta-analysis of Symptomatology and Treatment Approaches

10.21203/rs.3.rs-246493/v1 ◽

2021 ◽

Author(s):

Emmanuel Okechukwu Nna ◽

Michael Abel Alao ◽

Canice Anyachukwu ◽

Adanze Onyenonachi Asinobi ◽

Babatunde Ogunbosi ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Quality Assessment ◽

Observational Studies ◽

Meta Analysis ◽

Cochrane Library ◽

Treatment Approaches ◽

Pooled Prevalence ◽

Registration Number

Abstract Background:The burden of SAR COV-2 infection is not limited to the acute viraemia and its symptomatology but extends far beyond to include the long COVID, also known as post-COVID-19 syndrome,which may soon reach public health significance. We set out to produce a protocol for reliable and accurate systematic review and meta-analysis of the symptomatology and treatment approaches of long COVID globally.Methods:We developed a search strategy using MeSH terms, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Researchgate and Scopus. Only observational studies retrievable in the English Language will be included. The primary measurable outcome is the pooled prevalence of the symptoms of long COVID. The secondary outcomes include the summary effect sizes of the treatment approaches to the long COVID; the geographic, race, gender and age variations in symptomatology, and the quality of life of patients with long COVID. Identified studies will be screened, deduplicated, selected and data items extracted using DistillerSR software. All studies will be assessed for methodological, clinical and statistical heterogeneity. Assessment of meta-bias in the selected studies will be performed using the NIH Quality assessment tool for observational studies. Publication bias will be assessed using the funnel plot and Egger’s regression intercept. The pooled prevalence will be expressed with SE and 95% CI. The strength of evidence from this analysis will be assessed using the NIH Quality Assessment for Systematic Reviews and Meta-analysis.Discussion: This analysis will map globally the symptoms of long COVID and its correlates, exploring the influences of geographic locations, race, age and gender, thereby enabling a severity index on a global scale. It will examine in detail the treatment approaches to the long COVID and their impacts on the quality of life of patients. The evidence from this study will inform health policies toward the management of post-COVID-19 syndrome. The outcome of this study will be published in peer-reviewed scientific journal.Trial Registration Number:This protocol is registered with PROSPERO, registration number CRD42021236457

Download Full-text

Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044564 ◽

2020 ◽

Vol 10 (12) ◽

pp. e044564

Author(s):

Kaizhuang Huang ◽

Jiaying Lu ◽

Yaoli Zhu ◽

Tao Cheng ◽

Dahao Du ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Risk Factor ◽

Meta Analysis ◽

Coronary Intervention ◽

Cochrane Library ◽

Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

Download Full-text

Prevalence and Risk Factors of Relapse in Patients with ANCA-Associated Vasculitis Receiving Cyclophosphamide Induction: A Systematic Review and Meta-analysis of Large Observational Studies

Rheumatology ◽

10.1093/rheumatology/keaa667 ◽

2020 ◽

Author(s):

Peng He ◽

Jin-ping Hu ◽

Xiu-juan Tian ◽

Li-jie He ◽

Shi-ren Sun ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

Baseline Serum ◽

Anca Associated Vasculitis ◽

Hazard Ratios ◽

Post Hoc ◽

Cumulative Probabilities ◽

Relapse Rates

Abstract Background Clinical relapses are common in patients with ANCA-associated vasculitis (AAV). The aim of this systematic review was to estimate time-point prevalence and risk factors of relapse. Methods We searched PubMed, Embase, and Cochrane Library databases from their inception to March 30, 2020. Cohorts and post-hoc studies were included for the estimation of summary cumulative relapse rates (CRRs) and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Sensitivity and meta-regression analyses were also performed. Results Of the 42 eligible studies, 24 studies with 6236 participants were used for the pooled analyses of CRRs. The summary 1-year, 3-year, and 5-year CRRs were 0.12 (95% CI, 0.10–0.14), 0.33 (0.29–0.38), and 0.47 (0.42–0.52), respectively. In meta-regressions, the baseline age was positively associated with 1-year CRR. The proportion of granulomatosis with polyangiitis was positively associated with 5-year CRR. Twenty-eight studies with 5390 participants were used for the meta-analysis of risk factors for relapse, including a lower level of baseline serum creatine, proteinase 3 (PR3)-ANCA positivity at diagnosis, an ANCA rise, extrarenal organ involvement (including lung, cardiovascular, upper respiratory, and gastrointestinal involvement), intravenous (vs oral) cyclophosphamide induction, a shorter course of immunosuppressant maintenance, and maintenance with mycophenolate mofetil (vs azathioprine). Conclusions Our systematic review demonstrated that the 1-year, 3-year, and 5-year cumulative probabilities of relapse were ∼12%, 33%, and 47% in AAV patients receiving cyclophosphamide induction, respectively. Early identification of risk factors for relapse is helpful to the risk stratification of patients so as to achieve personalized treatment.

Download Full-text

The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

BMC Public Health ◽

10.1186/s12889-021-10993-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Amara Javed ◽

Mariyam Saleem ◽

Sundas Sajjad ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Population Based ◽

Included Study ◽

Cochrane Library ◽

Or Education ◽

Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

Download Full-text