Browsing by Subject "systematic review"

Now showing 1 - 8 of 8
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    Environmental health recommendations for Multidrug-Resistant Tuberculosis in low- and middle-income countries: a systematic review
    (2022) Nel, Amy; Rother, Hanna-Andrea; Miller, Mary E
    Despite efforts towards the management and prevention of Tuberculosis (TB) having shown some success, Multidrug-Resistant Tuberculosis (MDR-TB) may potentially compromise these endeavours. MDR-TB has the potential to become the most dominant form of TB in low- and middle-income countries (LMICs). The impact of environmental health factors on the optimization of health of MDR-TB infected individuals, as well as on the prevention of transmission to household contacts, is not well documented. Current Sustainable Development Goals (SDGs) aim to achieve inclusivity, sustainability and resilience, not only through economic and social changes, but also through environmental targets in order to achieve optimal health and well-being for all. However, without appropriate acknowledgment of the environment's influence on outcomes during TB treatment, these targets are potentially unattainable. Establishing the recommendations of environmental health risk factors for individuals living at home with MDR-TB will have important policy implications as well as assist in decision making for those affected with MDR-TB in LMICs, such as South Africa. This systematic review, therefore, sought to identify the environmental health factors in LMICs that affect treatment outcomes for individuals living at home with MDR-TB, to optimize their health during completion of their treatment regimen and prevent transmission to household contacts. Part A outlines the current literature available for such a topic as well as methodology used within the systematic search and analysis of included articles. Prominent environmental health exposure variables of interest that have previously been identified as having a significant role in TB transmission or influencing the well-being of infected individuals, were identified within the literature. These included air pollution, nutrition, migration, urbanization, smoking, alcohol, other substance use and housing. Outcomes of interest included optimization of health and prevention of MDR-TB transmission to household contacts. The article (part B) represents the results from the systematic search as well as the application to current policy recommendations. After screening and reviewing the full text of potential articles for inclusion (N = 87), only thirteen articles were eligible for inclusion into the final sample. All included studies were primary observational studies, examining the relationship between MDRTB and the pre-defined exposures and outcomes in populations ≥13 years of age. Environmental risk factors for household transmission of MDR-TB potentially included malnutrition but showed no significant relationship with overcrowding. There was disagreement as to whether smoking was as a significant predictor of mortality but findings did indicate that smoking did have a negative impact on sputum culture conversion among patients receiving treatment. Other substance use was found to have a significant role in the default of treatment. The use of alcohol was associated with poor treatment outcomes, default of treatment and lack of sputum culture conversion. In terms of household conditions, an association was found between substandard housing conditions and treatment default. Formal housing was associated with a decline in treatment default but a residential address change was associated with defaulting treatment. The results of the review presented contradictory results regarding the risk of mortality and underweight/overweight BMI estimates. The review potentially highlighted vulnerable population groups including gender groups, children and HIV positive individuals. Therefore, this systematic review highlighted the potential relationship between environmental risk factors and optimising the health of individuals on treatment for MDR-TB, as well as the role that promoting environmental health may play in preventing the transmission to household contacts. In conclusion, environmental risk factors should be incorporated into local health system strategies and global policy. This includes WHO targets in TB prevention efforts, as well as in action areas for the attainment of relevant SDGs (e.g. SDG 3 and SDG 5), to address the burden of MDR-TB and decrease MDR-TB transmission in LMICs, effectively and sustainably.
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    Excoriation (skin-picking) disorder: a systematic review of treatment options
    (2017) Lochner, Christine; Roos, Annerine; Stein, Dan
    Although pathological skin-picking has been documented in the medical literature since the 19th century, it has only recently been included as a distinct entity in psychiatric classification systems. In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition and the proposed International Classification of Diseases, Eleventh Revision, excoriation (skin-picking) disorder (ED), also known as neurotic excoriation, psychogenic excoriation, or dermatillomania), is described as recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. ED is listed as one of the obsessive–compulsive and related disorders, given its overlap with conditions such as trichotillomania (hair-pulling disorder). Arguably, its inclusion and delineation in the diagnostic nomenclature will lead to increased awareness of the condition, more research, and ultimately in treatment advances. This systematic review aims to provide readers with an up-to-date view of current treatment options for ED. A MEDLINE search of the ED treatment literature was conducted to collate relevant articles published between 1996 and 2017. The findings indicate that a number of randomized controlled trails on ED have now been published, and that current management options include behavioral therapy (habit reversal or acceptance-enhanced behavior therapy), and medication (selective serotonin reuptake inhibitors or N-acetyl cysteine).
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    Global burden of trichiasis in women as compared to men: Findings from the Global Trachoma Mapping Project
    (2019) Moyo, George; Courtright, Paul; Geneau, Robert
    The secondary analysis undertaken for this MPH dissertation examines the global prevalence of trichiasis in relation to gender in trachoma endemic countries. Part A is the research protocol which outlines the background and the process of this research. This study is a population-based analytical study using data from the Global Trachoma Mapping Project (GTMP). GTMP was a standardized population-based trachoma prevalence survey undertaken to provide trachoma prevalence estimates. GTMP data was collected using the World Health Organisation–recommended population based prevalence survey methodology. Trachoma suspect district were identified for inclusion and multistage random sampling was used to sample households for examination of residents for clinical trachoma. Part B presents the background and highlights the importance of this research by exploring the existing theoretical and empirical literature relevant to the topic. It describes how trachoma is transmitted, its clinical manifestations, and the way it can lead to blindness. Results from previous studies on gender and trichiasis are presented. Part C presents the research project in a format suitable for journal submission. The background of this research project is summarized and the meta-analysis is conducted at the global level, at the country level, the regional level, the state level and at the EU level but all in accordance to prevalence of trichiasis in the EUs. The implications of the findings are discussed and limitations in interpretation presented.
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    Stakeholder understandings of the Human Papillomavirus (HPV) vaccine in Sub-Saharan Africa: a qualitative systematic review
    (2019) Deignan, Caroline; Swartz, Alison; Cooper, Sara
    Cervical cancer rates in Sub-Saharan Africa (SSA) are amongst the highest in the world. The World Health Organization currently estimates that worldwide, cervical cancer will kill more than 443,000 women per year by 2030, of which 90% of deaths are predicted to occur in SSA. The Human Papillomavirus (HPV) vaccine provides primary protection against the most common cancer-causing strains of HPV that are responsible for cervical cancer. Over the last five years, there has been a slow increase in the number of African countries that have introduced the HPV vaccine via demonstration and pilot projects, and a minority of African countries that have incorporated the HPV vaccine into their National Immunisation Programmes. As part of this systematic review, a literature review was conducted and revealed that research has been conducted on top-down barriers and facilitators to HPV vaccine uptake and have found that poor health system capabilities, inaccessibility to medical care, low cervical cancer screening levels, inadequate infrastructure, finances, and health worker training are significant systemic barriers to HPV vaccination success in SSA. Little research has been conducted on demand-side or end-user perspectives of, and decisions around, the HPV vaccine. In order to complement existing research, and inform current and future implementation approaches, this qualitative systematic review explored stakeholder understandings of the HPV vaccine in SSA. This review searched the following databases: Embase (via Scopus), Scopus, MEDLINE (via PubMed), PubMed, EBSCOhost, Academic Search Premier, Africa-Wide Information, CINAHL, PsycARTICLES, PsycINFO, SocINDEX, Web of Science, and the Cochrane Controlled Register of Trials (CENTRAL) and found a total of 259 articles. Of these, 31 articles met the inclusion and exclusion criteria and were included in the review. Braun and Clarke’s six step process for conducting a thematic analysis was used for analysis and studies were assessed for quality using the Critical Appraisal Skills Programme (CASP) checklist. Three major themes emerged from the thematic analysis: knowledge is intertwined with misinformation; fear shapes contradictory perceptions about the HPV vaccine; and social norms and gender dynamics are relevant factors in how stakeholders understand the HPV vaccine in SSA. This review iterates the importance of first working with communities to gauge understandings of the HPV vaccine, before trying to implement change through education, sensitization and behavior change.
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    Systematic review of economic evaluations for paediatric pulmonary diseases
    (2021) Chitando, Mutsawashe; Cunnama, Lucy
    Background Pulmonary diseases are the leading causes of mortality globally amongst children under five years of age. Economic evaluations (EEs) guide decision-makers on which health care intervention to adopt to reduce paediatric pulmonary disease burden. Methods We systematically reviewed EEs for paediatric pulmonary diseases published globally between 2010 and 2020. We searched PubMed, Web of Science, MEDLINE, Paediatric Economic Database Evaluation (PEDE), and the Cochrane library. EEs included were specific to paediatric pulmonary diseases in a hospital setting and of children aged from zero to six years old. We extracted data items guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. We collected qualitative and quantitative data which we analysed in Microsoft Excel and R Software. Results 22 studies met the inclusion criteria. Seven of the articles were cost-effectiveness analyses, five cost-utility analyses, two cost-minimisation analyses, and eight cost analyses. Fourteen studies were conducted in high-income countries, eight in low-middle-income countries (LMICs). Ten studies were on asthma, nine on pneumonia, two on asthma and pneumonia, and one on tuberculosis. Quality assessment of the articles revealed some methodological inconsistencies across the articles. Conclusion Fewer EEs were conducted in LMICs, yet children from these countries are disproportionately affected by pulmonary diseases. Developing standardised methods for EEs and conducting more EEs and for paediatric pulmonary diseases in LMICs could allow for more evidence-based decision-making.
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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.
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    Two Decades of Desiccation Biology: A Systematic Review of the Best Studied Angiosperm Resurrection Plants
    (2021-12-16) Tebele, Shandry M; Marks, Rose A; Farrant, Jill M
    Resurrection plants have an extraordinary ability to survive extreme water loss but still revive full metabolic activity when rehydrated. These plants are useful models to understand the complex biology of vegetative desiccation tolerance. Despite extensive studies of resurrection plants, many details underlying the mechanisms of desiccation tolerance remain unexplored. To summarize the progress in resurrection plant research and identify unexplored questions, we conducted a systematic review of 15 model angiosperm resurrection plants. This systematic review provides an overview of publication trends on resurrection plants, the geographical distribution of species and studies, and the methodology used. Using the Preferred Reporting Items for Systematic reviews and Meta–Analyses protocol we surveyed all publications on resurrection plants from 2000 and 2020. This yielded 185 empirical articles that matched our selection criteria. The most investigated plants were Craterostigma plantagineum (17.5%), Haberlea rhodopensis (13.7%), Xerophyta viscosa (reclassified as X. schlechteri) (11.9%), Myrothamnus flabellifolia (8.5%), and Boea hygrometrica (8.1%), with all other species accounting for less than 8% of publications. The majority of studies have been conducted in South Africa, Bulgaria, Germany, and China, but there are contributions from across the globe. Most studies were led by researchers working within the native range of the focal species, but some international and collaborative studies were also identified. The number of annual publications fluctuated, with a large but temporary increase in 2008. Many studies have employed physiological and transcriptomic methodologies to investigate the leaves of resurrection plants, but there was a paucity of studies on roots and only one metagenomic study was recovered. Based on these findings we suggest that future research focuses on resurrection plant roots and microbiome interactions to explore microbial communities associated with these plants, and their role in vegetative desiccation tolerance.
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    What do we know about preventing school violence? A systematic review of systematic reviews
    (Taylor & Francis, 2017-01-30) Lester, Soraya; Lawrence, Cayleigh; Ward, Catherine L
    Many children across the world are exposed to school violence, which undermines their right to education and adversely affects their development. Studies of interventions for school violence suggest that it can be prevented. However, this evidence base is challenging to navigate. We completed a systematic review of interventions to reduce four types of school violence: (a) peer violence; (b) corporal punishment; (c) student-on-teacher violence and (d) teacher-on-student violence. Reviewers independently searched databases and journals. Included studies were published between 2005 and 2015; in English; considered school-based interventions for children and measured violence as an outcome. Many systematic reviews were found, thus we completed a systematic review of systematic reviews. Only systematic reviews on interventions for intimate partner violence (IPV) and peer aggression were found. These reviews were generally of moderate quality. Research on both types of violence was largely completed in North America. Only a handful of programmes demonstrate promise in preventing IPV. Cognitive behavioral, social-emotional and peer mentoring/mediation programmes showed promise in reducing the levels of perpetration of peer aggression. Further research needs to determine the long-term effects of interventions, potential moderators and mediators of program effects, program effects across different contexts and key intervention components.