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Reproductive Health Nov 2018Adolescence is the period between 10 and 19 years with peculiar physical, social, psychological and reproductive health characteristics. Rates of adolescent pregnancy... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Adolescence is the period between 10 and 19 years with peculiar physical, social, psychological and reproductive health characteristics. Rates of adolescent pregnancy are increasing in developing countries, with higher occurrences of adverse maternal and perinatal outcomes. The few studies conducted on adolescent pregnancy in Africa present inconsistent and inconclusive findings on the distribution of the problems. Also, there was no meta-analysis study conducted in this area in Africa. Therefore, this systematic review and meta-analysis were conducted to estimate the prevalence and sociodemographic determinant factors of adolescent pregnancy using the available published and unpublished studies carried out in African countries. Also, subgroup analysis was conducted by different demographic, geopolitical and administrative regions.
METHODS
This study used a systematic review and meta-analysis of published and unpublished studies in Africa. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was strictly followed. All studies in MEDLINE, PubMed, Cochrane Library, EMBASE, Google Scholar, CINAHL, and African Journals Online databases were searched using relevant search terms. Data were extracted using the Joanna Briggs Institute tool for prevalence studies. STATA 14 software was used to perform the meta-analysis. The heterogeneity and publication bias was assessed using the I statistics and Egger's test, respectively. Forest plots were used to present the pooled prevalence and odds ratio (OR) with 95% confidence interval (CI) of meta-analysis using the random effect model.
RESULT
This review included 52 studies, 254,350 study participants. A total of 24 countries from East, West, Central, North and Southern African sub-regions were included. The overall pooled prevalence of adolescent pregnancy in Africa was 18.8% (95%CI: 16.7, 20.9) and 19.3% (95%CI, 16.9, 21.6) in the Sub-Saharan African region. The prevalence was highest in East Africa (21.5%) and lowest in Northern Africa (9.2%). Factors associated with adolescent pregnancy include rural residence (OR: 2.04), ever married (OR: 20.67), not attending school (OR: 2.49), no maternal education (OR: 1.88), no father's education (OR: 1.65), and lack of parent to adolescent communication on sexual and reproductive health (SRH) issues (OR: 2.88).
CONCLUSIONS
Overall, nearly one-fifth of adolescents become pregnant in Africa. Several sociodemographic factors like residence, marital status, educational status of adolescents, their mother's and father's, and parent to adolescent SRH communication were associated with adolescent pregnancy. Interventions that target these factors are important in reducing adolescent pregnancy.
Topics: Adolescent; Africa; Female; Health Risk Behaviors; Humans; Peer Influence; Pregnancy; Pregnancy in Adolescence; Prevalence; Sexual Behavior
PubMed: 30497509
DOI: 10.1186/s12978-018-0640-2 -
The Journal of Infection Dec 2018Since the risk of multidrug-resistant tuberculosis (MDR-TB) may depend on the setting, we aimed to determine the associations of risk factors of MDR-TB across different... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Since the risk of multidrug-resistant tuberculosis (MDR-TB) may depend on the setting, we aimed to determine the associations of risk factors of MDR-TB across different regions.
METHODS
A systematic review and meta-analysis was performed with Pubmed and Embase databases. Information was retrieved on 37 pre-defined risk factors of MDR-TB. We estimated overall Mantel-Haenszel odds ratio as a measure of the association.
RESULTS
Factors of previous TB disease and treatment are the most important risk factors associated with MDR-TB. There was also a trend towards increased risk of MDR-TB for patients 40 years and older, unemployed, lacking health insurance, smear positive, with non-completion and failure of TB treatment, showing adverse drug reaction, non-adherent, HIV positive, with COPD and with M. Tuberculosis Beijing infection. Effect modification by geographical area was identified for several risk factors such as male gender, married patients, urban domicile, homelessness and history of imprisonment.
CONCLUSIONS
Assessment of risk factors of MDR-TB should be conducted regionally to develop the most effective strategy for MDR-TB control. Across all regions, factors associated with previous TB disease and treatment are essential risk factors, indicating the appropriateness of diagnosis, treatment and monitoring are an important requirements.
Topics: Antitubercular Agents; Global Health; Host Microbial Interactions; Humans; Latent Tuberculosis; Mycobacterium tuberculosis; Odds Ratio; Risk Assessment; Risk Factors; Tuberculosis, Multidrug-Resistant
PubMed: 30339803
DOI: 10.1016/j.jinf.2018.10.004 -
American Journal of Public Health Jul 2018The estimated lifetime prevalence of physical or sexual intimate partner violence (IPV) is 30% among women worldwide. Understanding risk and protective factors is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The estimated lifetime prevalence of physical or sexual intimate partner violence (IPV) is 30% among women worldwide. Understanding risk and protective factors is essential for designing effective prevention strategies.
OBJECTIVES
To quantify the associations between prospective-longitudinal risk and protective factors and IPV and identify evidence gaps.
SEARCH METHODS
We conducted systematic searches in 16 databases including MEDLINE and PsycINFO from inception to June 2016. The study protocol is registered with PROSPERO (CRD42016039213).
SELECTION CRITERIA
We included published and unpublished studies available in English that prospectively analyzed any risk or protective factor(s) for self-reported IPV victimization among women and controlled for at least 1 other variable.
DATA COLLECTION AND ANALYSIS
Three reviewers were involved in study screening. One reviewer extracted estimates of association and study characteristics from each study and 2 reviewers independently checked a random subset of extractions. We assessed study quality with the Cambridge Quality Checklists. When studies investigated the same risk or protective factor using similar measures, we computed pooled odds ratios (ORs) by using random-effects meta-analyses. We summarized heterogeneity with I and τ. We synthesized all estimates of association, including those not meta-analyzed, by using harvest plots to illustrate evidence gaps and trends toward negative or positive associations.
MAIN RESULTS
Of 18 608 studies identified, 60 were included and 35 meta-analyzed. Most studies were based in the United States. The strongest evidence for modifiable risk factors for IPV against women were unplanned pregnancy (OR = 1.66; 95% confidence interval [CI] = 1.20, 1.31) and having parents with less than a high-school education (OR = 1.55; 95% CI = 1.10, 2.17). Being older (OR = 0.96; 95% CI = 0.93, 0.98) or married (OR = 0.93; 95% CI = 0.87, 0.99) were protective.
CONCLUSIONS
To our knowledge, this is the first systematic, meta-analytic review of all risk and protective factors for IPV against women without location, time, or publication restrictions. Unplanned pregnancy and having parents with less than a high-school education, which may indicate lower socioeconomic status, were shown to be risk factors, and being older or married were protective. However, no prospective-longitudinal study investigated the associations between IPV against women and any community or structural factor outside the United States, and more studies investigated risk factors related to women as opposed to their partners. Public health implications. This review highlights that prospective evidence for perpetrator- and context-related risk and protective factors for women's experiences of IPV outside of the United States is lacking and urgently needed to inform global policy recommendations. The current evidence base of prospective studies suggests that, at least in the United States, education and sexual health interventions may be effective targets for preventing IPV against women, with young, unmarried women at greatest risk.
Topics: Age Factors; Crime Victims; Female; Humans; Interpersonal Relations; Intimate Partner Violence; Pregnancy; Pregnancy, Unplanned; Protective Factors; Risk Factors; Socioeconomic Factors; Substance-Related Disorders
PubMed: 29771615
DOI: 10.2105/AJPH.2018.304428 -
International Journal of Health Sciences 2022Although teenage pregnancy has declined in the last decade, it remains a major public health issue in Africa. Maternal mortality is common among teenagers due to their... (Review)
Review
OBJECTIVE
Although teenage pregnancy has declined in the last decade, it remains a major public health issue in Africa. Maternal mortality is common among teenagers due to their increased risk of obstetric and medical complications. In Africa, there is a lack of robust and comprehensive data on the prevalence and predictors of teenage pregnancy. As a result, this systematic review and meta-analysis were carried out to summarize evidence that will assist concerned entities in identifying existing gaps and proposing strategies to reduce teenage pregnancy in Africa.
METHODS
The review is registered by the international prospective register of systematic reviews (CRD42021275013). This search included all published and unpublished observational studies written in English between August 23, 2016, and August 23, 2021. The articles were searched using databases (PubMed, CINHAL [EBSCO], EMBASE, POPLINE, Google Scholar, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, and SCOPUS). Data synthesis and statistical analysis were conducted using STATA version 14 software. Forest plots were used to present the pooled prevalence and odds ratio (OR) with a 95% confidence interval (CI) of meta-analysis using the random effect model.
RESULTS
A total of 43,758 teenagers (aged 13-19) were included in 23 studies. In Africa, the overall pooled prevalence of teenage pregnancy was 30% (95% CI: 17-43). Western Africa had the highest prevalence of teenage pregnancy 33% (95% CI: 10-55). Age (18-19) (OR = 2.99 [95% CI = 1.124-7.927]), wealth index (OR = 1.84 [95% CI = 1.384-2.433]), and marital status (OR = 6.02 [95% CI = 2.348-15.43]) were predictors of teenage pregnancy in Africa.
CONCLUSION
In Africa, nearly one-third of teenagers become pregnant. Teenage pregnancy was predicted by age (18-19), wealth index, and marital status. Strengthening interventions aimed at increasing teenagers' economic independence, reducing child marriage, and increasing contraceptive use among married teenagers can help to prevent teenage pregnancy.
PubMed: 36475034
DOI: No ID Found -
Addiction (Abingdon, England) Sep 2021Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older demographics. The current paper is the first meta-analysis and systematic review, to our knowledge, to determine whether adult solitary drinking is associated with greater risk for alcohol problems.
METHODS
PsychINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42019147075) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Following the methodology used in our recent systematic review and meta-analysis on adolescent/young adult solitary drinking, we systematically reviewed solitary drinking measures/definitions, prevalence rates and associated demographic variables in adults. We then meta-analyzed (using random-effects models) associations between adult solitary drinking and alcohol use/problems, negative affect and negative/positive reinforcement-related variables (e.g. drinking to cope or for enhancement).
RESULTS
Solitary drinking was defined as drinking while physically alone in nearly all studies, but measures varied. Prevalence rates were generally in the 30-40% range, with some exceptions. In general, males were more likely than females to report drinking alone, and married individuals were less likely than unmarried individuals to report drinking alone; racial/ethnic differences were mixed. Meta-analytical results showed significant effects for the associations between solitary drinking and the following factors: alcohol consumption, r = 0.25, 95% confidence interval (CI) = 0.18, 0.33, k = 15, I = 97.41; drinking problems, r = 0.15, 95% CI = 0.10, 0.21, k = 14, I = 92.70; and negative reinforcement, r = 0.24, 95% CI = 0.14, 0.32, k = 11, I = 89.77; but not positive reinforcement, r = 0.02, 95% CI = 0.06, 0.09, k = 8, I = 76.18; or negative affect, r = 0.03, 95% CI = -0.02, 0.08, k = 8, I = 52.06. Study quality moderated the association between solitary drinking and negative affect (β = -0.07, P < 0.01) such that lower-quality studies were significantly associated with larger effect sizes. Study quality was generally low; the majority of studies were cross-sectional.
CONCLUSIONS
Solitary drinking appears to have a small positive association with alcohol problems.
Topics: Adaptation, Psychological; Adolescent; Aged; Alcohol Drinking; Alcohol-Related Disorders; Alcoholism; Cross-Sectional Studies; Female; Humans; Male; Young Adult
PubMed: 33245590
DOI: 10.1111/add.15355 -
Journal of the American Medical... Mar 2020Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings.
DESIGN
Systematic review and meta-analysis.
SETTING AND PARTICIPANTS
Community-dwelling older people with mean age ≥60 years.
METHODS
Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed.
RESULTS
A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62).
CONCLUSIONS AND IMPLICATIONS
Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.
Topics: Aged; Cross-Sectional Studies; Female; Frail Elderly; Frailty; Humans; Independent Living; Male; Marital Status; Middle Aged; Risk Factors
PubMed: 31740150
DOI: 10.1016/j.jamda.2019.09.017 -
The Journal of Sexual Medicine Dec 2023Unconsummated marriage (UCM) is the inability of the heterosexual married couple to have penovaginal sexual intercourse.
BACKGROUND
Unconsummated marriage (UCM) is the inability of the heterosexual married couple to have penovaginal sexual intercourse.
AIM
The study sought to systematically review current evidence regarding the etiological factors and clinical management of UCM.
METHODS
A comprehensive bibliographic search on the MEDLINE, Scopus, Web of Science, and Cochrane Library databases was performed in June 2023. Studies were selected if they described married couples who never had sexual intercourse in case report or case series evaluating the related causes and/or management and reporting data with qualitative, quantitative, or mixed methods. The review was reported according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) statement and registered in PROSPERO with ID CRD42023433040.
RESULTS
A total of 27 studies including 1638 males and 1587 females were selected. Eight (29.6%) articles were case reports involving a single couple and 19 (70.4%) studies were case series. Mean Murad score was 4.1 (range, 1-8) showing low-intermediate overall study quality. All articles had a level of evidence of 4. Most of studies were conducted in Egypt (n = 5 [18.4%]), Israel (n = 4 [14.9%]), and the United States (n = 4 [14.9%]). The mean age of males and females varied between 24.2 and 37.6 years and from 21 to 27.4 years, respectively. The reasons for the medical visit that led to the diagnosis of UCM were inability to consummate in 23 (85.2%) studies, inability to conceive in 1 (3.7%) article, and mixed in 3 (11.1%) articles. The mean duration of UCM varied from 7 days to 3.5 years. Eight studies involving both men and women showed that vaginismus (8.4%-81%) and erectile dysfunction (10.5%-61%) were the most common causes of UCM. Three articles reported that 16.6% to 26% of all UCM cases were due to both male and female factors. Sildenafil, tadalafil, intracavernosal injection, penile plication, female genital reconstructive surgery, vaginal dilators, lubricants, psychosexual therapy, and sex education were the various treatment modalities in 27 studies to achieve consummation rate of 66.6% to 100%.
STRENGTHS & LIMITATIONS
A strength is that this is the first systematic review covering the entire spectrum of UCM. Limitations comprised the low quality of most of the included articles and the large percentage of UCM cases probably not published.
CONCLUSION
Erectile dysfunction and vaginismus are the most reported causes of UCM; however, a strong psychological component certainly underlies a significant number of cases. A multidisciplinary approach based on strategic integration of sex education, medical therapy, psychosexual support, and surgical treatment would seem the most suitable option to manage couples with UCM.
Topics: Adult; Female; Humans; Male; Young Adult; Coitus; Dyspareunia; Erectile Dysfunction; Marriage; Sex Education; Vaginismus
PubMed: 37952223
DOI: 10.1093/jsxmed/qdad146 -
Frontiers in Global Women's Health 2023Although obstetric fistula has been extensively eliminated in high-income countries due to comprehensive obstetric health care services, in developing countries... (Review)
Review
BACKGROUND
Although obstetric fistula has been extensively eliminated in high-income countries due to comprehensive obstetric health care services, in developing countries including Ethiopia, many women and girls are still silently suffering from obstetric fistula due to early marriage, poor socioeconomic status, lack of access to skilled birth attendants, and limited awareness of obstetric fistula.
OBJECTIVE
To determine the magnitude of women's awareness of obstetric fistula and its contributing factors in Ethiopia.
METHODS
To perform this analysis, we strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations. To evaluate publication bias, we employed an Egger's test and an eye assessment of the funnel plot's symmetry. To look for signs of study heterogeneity, the Cochrane -test and I2 statistics were used. A Microsoft Excel spreadsheet was used to extract the data, and STATA version 14 was used to analyze it.
RESULTS
A total of six studies involving 3,024 women were included. The pooled prevalence of women's awareness of obstetric fistula in Ethiopia was 41.24% (95% CI; 32.94%-49.54%). Urban residence (AOR = 2.32, 95% CI: 1.40-3.85), giving birth at a health institution (AOR = 2.84, 95% CI: 1.92-4.21), having secondary or above educational status (AOR = 3.27, 95% CI: 2.15-4.97), receiving antenatal care follow-up (AOR = 2.73, 95% CI: 1.71-4.35), and participation in pregnant women's conferences (AOR = 4.64, 95% CI: 2.88-7.49) were factors associated with good awareness of obstetric fistula in women in Ethiopia.
CONCLUSION
The pooled prevalence of women's awareness of obstetric fistula was low. Urban residence, giving birth at a health institution, having secondary and above educational status, having antenatal care follow-up, and participating in pregnant women's conferences were factors associated with women's awareness of obstetric fistula. Therefore, enhancing women's awareness of obstetric fistula and promoting institutional delivery and antenatal follow-up is recommended. Furthermore, policymakers and stakeholders should empower women and pay particular attention to the neglected but important public health problem that is obstetric fistula.
PubMed: 37275209
DOI: 10.3389/fgwh.2023.1151083 -
Maternal and Child Health Journal Oct 2011Systematically review risks of an infant being born with low birth weight (LBW), preterm birth (PTB) or small for gestational age (SGA) among married and unmarried... (Meta-Analysis)
Meta-Analysis Review
Systematically review risks of an infant being born with low birth weight (LBW), preterm birth (PTB) or small for gestational age (SGA) among married and unmarried women. Medline, Embase, CINAHL, and bibliographies of identified articles were searched for English language studies. Studies reporting birth outcomes of married and unmarried (single and cohabitant) were included. Two reviewers independently collected data and assessed the quality of the studies for biases in sample selection, exposure assessment, confounder, analytical, outcome assessments, and attrition. Meta-analyses were performed using random effect model for both unadjusted and adjusted data and odds ratio (OR), and 95% confidence interval (CI) were calculated. Twenty-one studies of low to moderate risk of bias were included. Compared to married mothers unadjusted odds of (a) LBW was increased among unmarried (OR 1.46, 95%CI 1.25-1.71), single (OR 1.65, 95%CI 1.44-1.88) and cohabitating (OR 1.29, 95%CI 1.25-1.32) mothers; (b) PTB was increased among unmarried (OR 1.22, 95%CI 1.14-1.31), single (OR 1.54, 95%CI 1.39-1.72) and cohabitating (OR 1.15, 95%CI 1.08-1.23) mothers and (c) SGA birth was increased among unmarried (OR 1.45, 95%CI 1.32-1.61), single (OR 1.70, 95%CI 1.47-1.97) and cohabitating (OR 1.36, 95%CI 1.30-1.42) mothers. Meta-analyses of adjusted odds estimates confirmed these findings at marginally lower odds. Maternal unmarried status is associated with an increased risk of LBW, PTB and SGA births.
Topics: Female; Humans; Marital Status; Mothers; Pregnancy; Pregnancy Outcome
PubMed: 20690038
DOI: 10.1007/s10995-010-0654-z -
Obesity Reviews : An Official Journal... Nov 2023Overweight and obesity are consistently associated with lower physical activity (PA) levels and greater sedentary behavior (SB) in population studies. To date, no review... (Review)
Review
Overweight and obesity are consistently associated with lower physical activity (PA) levels and greater sedentary behavior (SB) in population studies. To date, no review has evaluated the factors associated with these behaviors in the specific population who have developed obesity/overweight. The aim of this systematic review was to identify the correlates/determinants of SB and PA in adults with overweight and obesity. Five databases were searched for studies, which reported factors or outcomes relating to PA or SB in adults living with overweight/obesity, published from 1980 to 2021. The factors were categorized using a socioecological model, strength, and direction of association. Of 34,058 articles retrieved, 45 studies were included, and 155 factors were identified. Self-efficacy, intrinsic motivation, exercise enjoyment, self-perceived good health, and social support were consistently associated with higher levels of PA. Consistent negative correlations were married females, increased BMI, obesity severity, pain, number of comorbidities, lack of time, energy, and willpower, and hilly terrain. Few studies (n = 12) examined SB, and no evidence for consistent associations were found. This review identified several correlates specific to PA in this population. Further studies are required to identify directionality and distal correlates for PA and all correlate levels of SB.
Topics: Female; Humans; Adult; Overweight; Sedentary Behavior; Exercise; Obesity; Body Mass Index
PubMed: 37549689
DOI: 10.1111/obr.13615