Faculty Opinions recommendation of Mortality of patients lost to follow-up in antiretroviral treatment programmes in resource-limited settings: systematic review and meta-analysis.

The level of smoking cessation support in hospitals are low, especially in resource limited settings. Current healthcare systems are not well organized to address the issue. This review aimed to evaluate the effectiveness of smoking cessation interventions initiated in health facilities in resource-limited settings. A systematic review using meta-analysis techniques was applied. Bibliographic databases included PubMed, Medline, LILACS, the United States Clinical Trials and the Cochrane Collaboration Library. Eligibility criteria included smoking cessation intervention studies were published in English or Vietnamese, from the year 1990 to 2018. Study designs were randomized controlled trials, quasi-randomized controlled trials, cohort studies and before and after studies. Populations were limited to those in low and middle-income countries. Interventions were limited smoking cessation programs conducted in health facilities. 17 studies had included for the reviewing. 12 studies had been assessed to the meta-analysis. The proportion of successful smoking cessation in 6 months follow-up were range from 11.7% to 62.2% for the intervention group. In 12 months, follow-up, the abstinence rate ranges from 13.6% to 73%. The popularly of medical staff support the intervention was the physicians (8/17, 47.1%) and doctor (5/17, 29.4%). The evidence from our study suggests that the abstinence rate can be affected by the supporting of medical staff follow the smoking cessation (SC) program.

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Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00822-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hafte Kahsay Kebede ◽

Lillian Mwanri ◽

Paul Ward ◽

Hailay Abrha Gesesew

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Hiv Care ◽

Care Services ◽

Validity Assessment ◽

Sub Saharan ◽

Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

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Antiretroviral Treatment and Follow-up of HIV-infected Children in Resource-limited Settings

Global HIV/AIDS Medicine ◽

10.1016/b978-1-4160-2882-6.50059-9 ◽

2008 ◽

pp. 621-635

Author(s):

Sibyl Geelen ◽

Philippa Musoke

Keyword(s):

Antiretroviral Treatment ◽

Resource Limited Settings ◽

Resource Limited

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Self-transfer and mortality amongst adults lost to follow-up in ART programmes in low- and middle-income countries: systematic review and meta-analysis

Tropical Medicine & International Health ◽

10.1111/tmi.12434 ◽

2015 ◽

Vol 20 (3) ◽

pp. 365-379 ◽

Cited By ~ 54

Author(s):

Lynne S. Wilkinson ◽

Jolene Skordis-Worrall ◽

Olawale Ajose ◽

Nathan Ford

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Middle Income ◽

Middle Income Countries ◽

Lost To Follow Up ◽

Low And Middle Income

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Effectiveness of Pediatric Antiretroviral Therapy in Resource‐Limited Settings: A Systematic Review and Meta‐analysis

Clinical Infectious Diseases ◽

10.1086/648079 ◽

2009 ◽

Vol 49 (12) ◽

pp. 1915-1927 ◽

Cited By ~ 79

Author(s):

Andrea L. Ciaranello ◽

Yuchiao Chang ◽

Andrea V. Margulis ◽

Adam Bernstein ◽

Ingrid V. Bassett ◽

...

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Meta Analysis ◽

Resource Limited Settings ◽

Resource Limited

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Yield of HIV-associated tuberculosis during intensified case finding in resource-limited settings: a systematic review and meta-analysis

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(09)70326-3 ◽

2010 ◽

Vol 10 (2) ◽

pp. 93-102 ◽

Cited By ~ 82

Author(s):

Katharina Kranzer ◽

Rein MGJ Houben ◽

Judith R Glynn ◽

Linda-Gail Bekker ◽

Robin Wood ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Case Finding ◽

Resource Limited Settings ◽

Resource Limited ◽

Intensified Case Finding

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The Statistical Fragility of Platelet-Rich Plasma in Rotator Cuff Surgery: A Systematic Review and Meta-analysis

The American Journal of Sports Medicine ◽

10.1177/0363546521989976 ◽

2021 ◽

pp. 036354652198997

Author(s):

Robert L. Parisien ◽

Cooper Ehlers ◽

Antonio Cusano ◽

Paul Tornetta ◽

Xinning Li ◽

...

Keyword(s):

Systematic Review ◽

Decision Making ◽

Rotator Cuff ◽

Clinical Decision Making ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Clinical Decision ◽

Statistical Stability ◽

Lost To Follow Up

Background: The practice of evidence-based medicine relies on objective data to guide clinical decision-making with specific statistical thresholds conveying study significance. Purpose: To determine the utility of applying the fragility index (FI) and the fragility quotient (FQ) analysis to randomized controlled trials (RCTs) evaluating the utilization of platelet-rich plasma (PRP) in rotator cuff repairs (RCRs). Study Design: Systematic review and meta-analysis. Methods: RCTs pertaining to the utilization of PRP in surgical RCRs published in 13 peer-reviewed journals from 2000 to 2020 were evaluated. The FI was determined by manipulating each reported outcome event until a reversal of significance was appreciated. The associated FQ was determined by dividing the FI by the sample size. Results: Of the 9746 studies screened, 19 RCTs were ultimately included for analysis. The overall FI incorporating all 19 RCTs was only 4, suggesting that the reversal of only 4 events is required to change study significance. The associated FQ was determined as 0.092. Of the 43 outcome events reporting lost to follow-up data, 13 (30.2%) represented lost to follow-up >4. Conclusion: Our analysis suggests that RCTs evaluating PRP for surgical RCRs may lack statistical stability with only a few outcome events required to alter trial significance. Therefore, we recommend the reporting of an FI and an FQ in conjunction with P value analysis to carefully interpret the integrity of statistical stability in future comparative trials. Clinical Relevance: Clinical decisions are often informed by statistically significant results. Thus, a true understanding of the robustness of the statistical findings informing clinical decision-making is of critical importance.

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