Browsing by Author "Hohlfeld, Ameer"

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    Open Access
    Defining and conceptualising data harmonisation: a scoping review protocol
    (BioMed Central, 2018-12-06) Schmidt, Bey-Marrié; Colvin, Christopher J; Hohlfeld, Ameer; Leon, Natalie
    Abstract Background Data harmonisation is an important intervention to strengthen health systems functioning. It has the potential to enhance the production, accessibility and utilisation of routine health information for clinical and service management decision-making. It is important to understand the range of definitions and concepts of data harmonisation, as well as how its various social and technical components and processes are thought to lead to better health management decision-making. However, there is lack of agreement in the literature, and in practice, on definitions and conceptualisations of data harmonisation, making it difficult for health system decision-makers and researchers to design, implement, evaluate and compare data harmonisation interventions. This scoping review aims to synthesise (1) definitions and conceptualisations of data harmonisation as well as (2) explanations in the literature of the causal relationships between data harmonisation and health management decision-making. Methods This review follows recommended methodological stages for scoping studies. We will identify relevant studies (peer-reviewed and grey literature) from 2000 onwards, in English only, and with no methodological restriction, in various electronic databases, such as CINAHL, MEDLINE via PubMed and Global Health. Two reviewers will independently screen records for potential inclusion for the abstract and full-text screening stages. One reviewer will do the data extraction, analysis and synthesis, with built-in reliability checks from the rest of the team. We will use a combination of sampling techniques, including two types of ‘purposeful sampling’, a methodological approach that is particularly suitable for a scoping review with our objectives. We will provide (a) a numerical synthesis of characteristics of the included studies and (b) a narrative synthesis of definitions and explanations in the literature of the relationship between data harmonisation and health management decision-making. Discussion We list potential limitations of this scoping review. To our knowledge, this scoping review will be the first to synthesise definitions and conceptualisations of data harmonisation in the literature as well as the underlying explanations in the literature of the causal links between data harmonisation and health management decision-making.
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    Open Access
    The Epidemiology of Auditory Dysfunction in Type 2 Diabetic Adults in Africa: 4 A Systematic Review and Meta-analysis
    (2022) Fihla, Achuma; Engel, Mark; Petersen, Lucretia; Hohlfeld, Ameer
    Background: There is a growing rate of diabetes related hearing loss (HL) worldwide. However, in under-developed countries, HL is still under-recognised as a complication of type 2 diabetes mellitus (T2DM). Although Africa presents a significant rise in T2DM every year, it is met with limited resources to assist its growing and ageing population. Objectives: This systematic review and meta-analysis brings awareness to diabetes-related HL in the form of reliable medical evidence measuring the prevalence of T2DM-related HL in an African population. Methods: Studies were screened using Rayyan QCRI. STATA software and the random-effects metaanalysis model was used to aggregate prevalence estimates with a 95% confidence interval. The Freeman Tukey Transformation was used to account for between study variability. The study protocol is published in PROSPERO international Register of Systematic Reviews (registration number CRD42021227801). Results: We identified a total of 99 studies, 14 duplicates were removed and 67 were excluded. After full review only five studies were included for quantitative synthesis. All the studied were crosssectional and used purposive sampling as their recruitment method. Conclusions: Findings show most participants with T2DM experienced mild HL and slight delays in objective hearing assessments. Audiometric resources and qualified Audiologists are scarce in Africa. Therefore, the available evidence does not justify the added costs needed for routine audiometric assessments for patients with T2DM. However, it does serve to recommend prioritising further research regarding risk factors associated with developing auditory disorders in people with T2DM.
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    The Prevalence of Antiretroviral-Therapy-related Adverse Reactions, Hospitalisation, and Mortality among People Living with HIV in Africa-A systematic review and Meta-Analysis
    (2022) Moirana, Elizabeth Lorivi; Shung, King Maylene; Hohlfeld, Ameer
    Introduction: Medicines are an important component of any health system. Even though the importance of medicines in the health system is indisputable, one of the major concerns remains the risk of adverse drug reactions when used by consumers. Adverse drug reactions place a burden on the healthcare system, usually as a result of complications requiring hospital admission or extended hospital admissions. In Africa, about 28.6% of adverse drug reactions reported in Africa were due to antiretroviral therapy. Recently, the adoption of the “test and treat” policy by the World Health Organisation increased the number of people receiving antiretroviral therapy. Therefore, this systematic review was conducted to explore the magnitude of antiretroviral therapy-related adverse drug reactions hospitalisations, and mortalities in the region, following the increase in people initiating therapy, and the implications to the service delivery component of the healthcare system. Methods: In March 2021, PubMed, EBSCOHost, and SCOPUS, databases were systematically searched for appropriate articles. The selection of articles was based on predefined inclusion and exclusion criteria. Data from included articles were extracted as per a set of defined criteria into a data extraction form. A meta-analysis was done using Stata package software 15.0 using Stata “metaprop” command. Results: The pooled prevalence of adverse drug reactions hospitalisations in all studies was 26.5% (95% confidence interval:18.4,35.4) and that of mortality was 6.1% (95% confidence interval:2.1,11.7). The most prevalent adverse reactions reported include hepatotoxicity, kidney injury, lactic acidosis, skin, neurologic, and hematologic reactions. The antiviral implicated, are non-nucleoside reverse transcriptase inhibitors, nucleoside/tide reverse transcriptase inhibitors, and protease inhibitors. The pediatric population was underrepresented as only two studies included pediatric patients. The economic impact of adverse reactions was impossible to estimate, as only one study reported on financial implications. Conclusion: Antiretroviral therapy-related adverse reactions hospitalisations and mortalities have a high prevalence in Africa. There are concerns about age-related morbidities and lifestyle diseases as risk factors related to adverse reactions. To adequately combat adverse reactions associated with antiretrovirals, African country health systems need multidisciplinary actions to strengthen strategies for prediction, identification, reporting, and prevention of adverse reaction occurrence.