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PeerJ 2022HIV-positive status disclosure for children is challenging for family members, guardians, and healthcare professionals. Disclosure is very challenging, particularly for... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
HIV-positive status disclosure for children is challenging for family members, guardians, and healthcare professionals. Disclosure is very challenging, particularly for children, yet no systematic synthesis of evidence accurately measures HIV-positive status disclosure in children. This systematic review and meta-analysis study aimed to quantify the national prevalence of pediatric HIV-positive status disclosure in Ethiopia and identify factors associated with HIV-positive status disclosure.
METHOD
We systematically searched PubMed, EMBASE, Web of Science databases, and google scholar for relevant published studies. Studies published in the English language and conducted with cohort, case-control, and cross-sectional designs were eligible for the review. The primary and secondary outcomes of the study were HIV-positive status disclosure and factors associated with HIV-positive status disclosure, respectively. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. A random effect- model was used to estimate the pooled prevalence of HIV-positive status disclosure. Heterogeneity and publication bias of included studies was determined using I and Egger's test, respectively.
RESULT
From 601 records screened, nine relevant studies consisting of 2,442 HIV-positive children were included in the analysis. The overall pooled prevalence of HIV-positive status disclosure among children living with HIV/AIDS in Ethiopia was 31.2% (95% CI [23.9-38.5]). HIV-negative status of caregivers (AOR: 2.01; 95% CI [1.28-3.18]), long duration on ART (greater than 5 years) (AOR: 3.2; 95% CI [1.77-5.78]) and older age of the child (>10 years) (AOR: 7.2; 95% CI [4.37-11.88]) were significantly associated with HIV-positive status disclosure.
CONCLUSION
Low prevalence of pediatric HIV-positive status disclosure was observed in Ethiopia. The longer duration of ART, the HIV-negative status of the caregiver, and older age greater than 10 years were the predictors of pediatric HIV-positive status disclosure. Health system leaders and policymakers shall design training and counseling programs for healthcare professionals and caregivers to enhance their awareness about HIV-positive status disclosure.
TRIAL REGISTRATION
This review was registered under PROSPERO and received a unique registration number, CRD42019119049.
Topics: Humans; Child; Disclosure; HIV Infections; Ethiopia; Cross-Sectional Studies; HIV Seropositivity
PubMed: 36032949
DOI: 10.7717/peerj.13896 -
BMC Infectious Diseases Jun 2019Late presentation to HIV/AIDS care which is attended by problems like, poor treatment outcomes, early development of opportunistic infections, increased healthcare... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Late presentation to HIV/AIDS care which is attended by problems like, poor treatment outcomes, early development of opportunistic infections, increased healthcare costs, and mortality is a major problem in Ethiopia. Although evidences are available on the prevalence and associated factors of late presentation to HIV/AIDS care, discrepancies among findings are appreciated. Thus, the country has faced difficulties of having a single estimated data.
OBJECTIVE
This study aimed to estimate the pooled prevalence of late presentation of HIV positive adults to HIV/AIDS care and its predictors in Ethiopia.
METHOD
We searched all available articles through Google Scholar, PubMed, Web of Sciences, and EMBASE databases. Additionally, we accessed articles from the Ethiopian institutional online research repositories and reference lists of included studies. We included cohort, case- control, and cross-sectional studies in our review. Besides, we utilized the weighted inverse variance random-effects model. The total percentage of variation among studies due to heterogeneity was determined by I statistic. Searching was limited to studies conducted in Ethiopia and published in the English language. Publication bias was checked by Egger's regression test.
RESULTS
A total of 8 studies with 7, 568 participants were included. The pooled prevalence of late presentation to HIV/AIDS care was 52.89% (95%CI: 35.37, 70.40). The odds of late presentation to HIV/AIDS care of frequent alcohol users [3.67(95% CI = 1.52-5.83)], high fear of stigma [3.90 (95% CI = 1.51-6.28)], chronic illness [3.34(95% CI = 1.52-5.16)], and the presence of symptoms at the time of HIV diagnosis [3.06 (95% CL = 1.18-4.94)] were higher compared to participants who did not experience the preceding.
CONCLUSION
The prevalence of late presentation of HIV positive adults to HIV/AIDS care was high in Ethiopia. Frequent alcohol use, high fear of stigma, chronic illness, and the presence of symptoms at the time of HIV diagnosis were associated with high odds of late presentation to HIV/AIDS care.
TRIAL REGISTRATION
Registered in PROSPERO databases with the registration number of CRD42018081840 .
Topics: Ethiopia; HIV Infections; Humans; Prevalence; Risk Factors; Time-to-Treatment
PubMed: 31208360
DOI: 10.1186/s12879-019-4156-3 -
European Journal of Medical Research Oct 2022Patients with immunodeficiency are usually more prone to worse outcomes of infectious diseases. However, there are some disagreements in the context of COVID-19, for... (Review)
Review
INTRODUCTION
Patients with immunodeficiency are usually more prone to worse outcomes of infectious diseases. However, there are some disagreements in the context of COVID-19, for example, in patients with human immunodeficiency virus (HIV). Herein, we aimed to systematically review the risk and predictors of COVID-19 mortality in people with primary or secondary immunodeficiency.
METHODS
PubMed, Scopus, Web of Science, and Science Direct were searched. We followed a two-step screening process to identify eligible results. We first reviewed the title and abstract of the records and the unqualified studies were removed. Then, their full texts were evaluated based on their coherence with the purpose and inclusion/exclusion criteria, and those eligible for qualitative synthesis were included.
RESULTS
Twenty-two articles were included, which investigated a total of 109,326 with primary or secondary immunodeficiencies. Three studies investigated the pediatric and infant population, while other studies were conducted on the adult population. Overall, studies on both primary and secondary immunodeficiency conflicted as some reported higher and some mentioned lower mortality rates in patients with immunodeficiency.
CONCLUSIONS
Overall, there were two points of view in both types of immunodeficiencies. The first is the classical viewpoint that all immunodeficient patients are at a higher risk of infection leading to a higher mortality rate. The second types of studies found that immunodeficiency might play a less important or even an inverse role in mortality rates by lowering the severity of the inflammatory response. However, it is important to take note to comorbidities, such as DM, HTN, CAD, ESRD, history of lower respiratory infection, etc., and demographic factors, such as obesity and age > 70 years, as they appear to influence the mortality rate, especially in patients with secondary immunodeficiency.
Topics: Adult; Aged; COVID-19; Child; Comorbidity; HIV Infections; Humans; SARS-CoV-2
PubMed: 36209202
DOI: 10.1186/s40001-022-00824-7 -
International Journal of Audiology Jan 2022Hearing loss (HL) is one of the most common disorders present at birth. Parents' management of their child's hearing aids (HAs) and regular follow-up with healthcare...
CONTEXT
Hearing loss (HL) is one of the most common disorders present at birth. Parents' management of their child's hearing aids (HAs) and regular follow-up with healthcare providers HA are fundamental components of effective intervention.
OBJECTIVE
The primary objective of this systematic review was to synthesise the current literature on HA use in the paediatric population, and the secondary objective was to review the factors associated with HA use.
METHODS
Electronic databases, including MEDLINE, EMBASE, CINAHL, and LLBA from 2005 to 2019, were searched. Two reviewers individually screened potentially relevant articles over two phases.
RESULTS
Fifteen studies met this review criteria. Four studies reported HA use based on data logging records. In nine studies, the amount of HA use was evaluated based on parents' reports, and three studies concluded that parents overestimate their child's HA use. Age, degree of HL and parents' education level were the most frequently reported factors associated with a child's amount of HA use.
CONCLUSIONS
The results of this review will provide a foundation for future studies on the importance of monitoring HA use and the impact of consistent HA use on the language development of children with HL.
Topics: Child; Deafness; Hearing; Hearing Aids; Hearing Loss; Hearing Tests; Humans; Infant, Newborn; Parents
PubMed: 34407727
DOI: 10.1080/14992027.2021.1962014 -
PLoS Medicine Feb 2014Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention approaches. We performed a systematic review and meta-analysis to estimate maternal HIV incidence during pregnancy/postpartum and to compare mother-to-child HIV transmission (MTCT) risk among women with incident versus chronic infection.
METHODS AND FINDINGS
We searched PubMed, Embase, and AIDS-related conference abstracts between January 1, 1980, and October 31, 2013, for articles and abstracts describing HIV acquisition during pregnancy/postpartum. The inclusion criterion was studies with data on recent HIV during pregnancy/postpartum. Random effects models were constructed to pool HIV incidence rates, cumulative HIV incidence, hazard ratios (HRs), or odds ratios (ORs) summarizing the association between pregnancy/postpartum status and HIV incidence, and MTCT risk and rates. Overall, 1,176 studies met the search criteria, of which 78 met the inclusion criterion, and 47 contributed data. Using data from 19 cohorts representing 22,803 total person-years, the pooled HIV incidence rate during pregnancy/postpartum was 3.8/100 person-years (95% CI 3.0-4.6): 4.7/100 person-years during pregnancy and 2.9/100 person-years postpartum (p = 0.18). Pooled cumulative HIV incidence was significantly higher in African than non-African countries (3.6% versus 0.3%, respectively; p<0.001). Risk of HIV was not significantly higher among pregnant (HR 1.3, 95% CI 0.5-2.1) or postpartum women (HR 1.1, 95% CI 0.6-1.6) than among non-pregnant/non-postpartum women in five studies with available data. In African cohorts, MTCT risk was significantly higher among women with incident versus chronic HIV infection in the postpartum period (OR 2.9, 95% CI 2.2-3.9) or in pregnancy/postpartum periods combined (OR 2.3, 95% CI 1.2-4.4). However, the small number of studies limited power to detect associations and sources of heterogeneity.
CONCLUSIONS
Pregnancy and the postpartum period are times of persistent HIV risk, at rates similar to "high risk" cohorts. MTCT risk was elevated among women with incident infections. Detection and prevention of incident HIV in pregnancy/postpartum should be prioritized, and is critical to decrease MTCT.
Topics: Africa; Anti-HIV Agents; Female; HIV Infections; Humans; Incidence; Infectious Disease Transmission, Vertical; Multivariate Analysis; Odds Ratio; Postpartum Period; Pregnancy; Pregnancy Complications, Infectious; Prognosis; Risk Assessment; Risk Factors
PubMed: 24586123
DOI: 10.1371/journal.pmed.1001608 -
Journal of the International AIDS... 2014To assess evidence of an association between intimate partner violence (IPV) and HIV infection among women. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
To assess evidence of an association between intimate partner violence (IPV) and HIV infection among women.
METHODS
Medline/PubMed, Embase, Web of Science, EBSCO, Ovid, Cochrane HIV/AIDS Group's Specialized Register and Cochrane Central Register of Controlled Trials were searched up to 20 May 2013 to identify studies that examined the association between IPV and HIV infection in women. We included studies on women aged ≥15 years, in any form of sexually intimate relationship with a male partner.
RESULTS
Twenty-eight studies [(19 cross-sectional, 5 cohorts and 4 case-control studies) involving 331,468 individuals in 16 countries - the US (eight studies), South Africa (four studies), East Africa (10 studies), India (three studies), Brazil (one study) and multiple low-income countries (two studies)] were included. Results were pooled using RevMan 5.0. To moderate effect estimates, we analyzed all data using the random effects model, irrespective of heterogeneity level. Pooled results of cohort studies indicated that physical IPV [pooled RR (95% CI): 1.22 (1.01, 1.46)] and any type of IPV [pooled RR (95% CI): 1.28 (1.00, 1.64)] were significantly associated with HIV infection among women. Results of cross-sectional studies demonstrated significant associations of physical IPV with HIV infection among women [pooled OR (95% CI): 1.44 (1.10, 1.87)]. Similarly, results of cross-sectional studies indicated that combination of physical and sexual IPV [pooled OR (95% CI): 2.00 (1.24, 3.22) and any type of IPV [pooled OR (95% CI): 1.41 (1.16, 1.73)] were significantly associated with HIV infection among women.
CONCLUSIONS
Available evidence suggests a moderate statistically significant association between IPV and HIV infection among women. To further elucidate the strength of the association between IPV and HIV infection among women, there is a need for high-quality follow-up studies conducted in different geographical regions of the world, and among individuals of diverse racial/cultural backgrounds and varying levels of HIV risks.
Topics: Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Domestic Violence; Female; HIV Infections; Humans; Male; Risk Factors; Sexual Partners
PubMed: 24560342
DOI: 10.7448/IAS.17.1.18845 -
Clinical Infectious Diseases : An... Jun 2016We conducted a systematic review and meta-analysis to evaluate the incidence and prevalence of 14 opportunistic infections (OIs) and other infections as well as the... (Meta-Analysis)
Meta-Analysis Review
Incidence and Prevalence of Opportunistic and Other Infections and the Impact of Antiretroviral Therapy Among HIV-infected Children in Low- and Middle-income Countries: A Systematic Review and Meta-analysis.
BACKGROUND
We conducted a systematic review and meta-analysis to evaluate the incidence and prevalence of 14 opportunistic infections (OIs) and other infections as well as the impact of antiretroviral therapy (ART) among human immunodeficiency virus (HIV)-infected children (aged <18 years) in low- and middle-income countries (LMICs), to understand regional burden of disease, and inform delivery of HIV services.
METHODS
Eligible studies described the incidence of OIs and other infections in ART-naive and -exposed children from January 1990 to November 2013, using Medline, Global Health, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Knowledge, and Literatura Latino Americana em Ciências da Saúde databases. Summary incident risk (IR) and prevalent risk for each OI in ART-naive and ART-exposed children were calculated, and unadjusted odds ratios calculated for impact of ART. The number of OI cases and associated costs averted were estimated using the AIDS impact model.
RESULTS
We identified 4542 citations, and 88 studies were included, comprising 55 679 HIV-infected children. Bacterial pneumonia and tuberculosis were the most common incident and prevalent infections in both ART-naive and ART-exposed children. There was a significant reduction in IR with ART for the majority of OIs. There was a smaller impact on bacterial sepsis and pneumonia, and an increase observed for varicella zoster. ART initiation based on 2010 World Health Organization guidelines criteria for ART initiation in children was estimated to potentially avert >161 000 OIs (2013 UNAIDS data) with estimated cost savings of at least US$17 million per year.
CONCLUSIONS
There is a decrease in the risk of most OIs with ART use in HIV-infected children in LMICs, and estimated large potential cost savings in OIs averted with ART use, although there are greater uncertainties in pediatric data compared with that of adults.
Topics: AIDS-Related Opportunistic Infections; Adolescent; Anti-Retroviral Agents; Child; Child, Preschool; Developing Countries; HIV Infections; Humans; Incidence; Infant; Infant, Newborn; Prevalence
PubMed: 27001796
DOI: 10.1093/cid/ciw139 -
The prevalence of hearing loss and use of hearing aids among adults in Germany: a systematic review.European Archives of... Apr 2019Worldwide approximately 360 million people suffer from hearing impairment, 328 million of whom are adults. Up to now there has been no systematic evaluation of any...
BACKGROUND
Worldwide approximately 360 million people suffer from hearing impairment, 328 million of whom are adults. Up to now there has been no systematic evaluation of any representative epidemiological data on the prevalence of hearing loss among adults in Germany. The present paper is intended to investigate this within the framework of a systematic review.
METHODS
A systematic literature search was carried out in electronic databases as well as by means of hand-searching. Studies published after 1975 and indicating the prevalence or incidence of hearing impairment among German adults were included. Study selection, data extraction and additional quality assessments were made by two independent reviewers.
RESULTS
By means of a systematic literature search it was possible to identify 6 sources, which provided solely cross-sectional data, whereby the reported data are based on a study population of between some hundred and 10 million people living in Germany. The prevalences ascertained showed a broad range of between 16% and 25% and varied according to age, study setting, definition of hearing loss and method of data capture. At present there are no utilizable data on the extent of the use of hearing aids.
DISCUSSION
The present review demonstrates clearly that evidence-based information relating to Germany can only be made on the basis of a clear definition of hearing loss within the framework of an up-to-date and representative epidemiological study carried out with appropriate methodology. In view of the high prevalence of illnesses causing hearing impairment and of the risks to health associated with untreated hearing impairment as well as of socio-economic costs, such an epidemiological study is of great social significance.
Topics: Adult; Aged; Aged, 80 and over; Deafness; Female; Germany; Hearing Aids; Hearing Loss; Humans; Male; Middle Aged; Prevalence
PubMed: 30737583
DOI: 10.1007/s00405-019-05312-z -
The Cochrane Database of Systematic... Oct 2011Anemia is common in persons with HIV infection and is associated with poor prognosis. There is a need to assess the effects of anemia treatments, and to determine... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Anemia is common in persons with HIV infection and is associated with poor prognosis. There is a need to assess the effects of anemia treatments, and to determine whether these interventions are beneficial.
OBJECTIVES
To determine the efficacy and safety of treatments for anemia in people with HIV infection and AIDS.
SEARCH STRATEGY
The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 10, 2010), MEDLINE (1980-November 25, 2010), EMBASE (1980-November 25, 2010), LlLACS (1982 to November 25, 2010), Africa Index Medicus (up to November 9, 2010), ISI Web of Knowledge (2005 to October 9, 2010), Scirus (October 9, 2010) reference lists of relevant articles. We asked the Cochrane HIV/AIDS and Pregnancy and Childbirth Groups to check their Specialised Registers. We also checked the reference lists of all trials identified by the above methods.
SELECTION CRITERIA
Randomized trials assessing the effects of treatments for anemia in people diagnosed with HIV infection. There were no age restrictions.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed relevant studies for inclusion. Data extraction and quality assessment of relevant studies was performed by two authors and checked by the other two authors.
MAIN RESULTS
Six trials with a high risk of bias, including 537 patients, met the inclusion criteria. These trials only covered recombinant Human erythropoietin alfa (rHuEPO). Two of them including adult and paediatric participants (84 participants and 4 events) comparing rHuEPO to placebo did not reduce the risk of mortality with a follow up to 12 weeks (pooled RR 0.56, 95% confidence interval (CI) 0.08 to 4.05, I(2) = 0%). Any trials that compared rHuEPO to placebo did not show any benefit on hematological values response, number of patients transfused, or number of packed red cell transfused. Two trial compared the effects of two rHuEPO dosing regimens on hemoglobin value and quality of life, but the effects are unclear. Three RCT reported high risk of attrition bias; therefore, were not included in a meta-analysis.
AUTHORS' CONCLUSIONS
This updated Cochrane review provides evidence that rHuEPO compared with placebo does not reduce mortality, does not reduce transfusion requirements, did not increase hemoglobin levels, and did not improve quality of life in HIV-infected patients with anemia. The results are based on six RCTs with high risk of bias. Therefore prescription of this intervention for treating anemia in patients with AIDS is not justified, unless new evidence from a large high quality trial alters this conclusion.
Topics: Acquired Immunodeficiency Syndrome; Anemia; Erythropoietin; Hematinics; Humans; Randomized Controlled Trials as Topic; Recombinant Proteins
PubMed: 21975747
DOI: 10.1002/14651858.CD004776.pub3 -
United European Gastroenterology Journal Nov 2022There are several options for the surgical management of GERD in adults. Previous guidelines and systematic reviews have compared the effects of total fundoplication... (Meta-Analysis)
Meta-Analysis
UEG and EAES rapid guideline: Update systematic review, network meta-analysis, CINeMA and GRADE assessment, and evidence-informed European recommendations on surgical management of GERD.
BACKGROUND
There are several options for the surgical management of GERD in adults. Previous guidelines and systematic reviews have compared the effects of total fundoplication versus pooled effects of different techniques of partial fundoplication.
OBJECTIVE
To develop evidence-informed, trustworthy, pertinent recommendations on the use of total, posterior partial and anterior partial fundoplications for the management of GERD in adults.
METHODS
We performed an update systematic review, network meta-analysis, and evidence appraisal using the GRADE and the Confidence in Network Meta-Analysis methodologies. An international, multidisciplinary panel of surgeons, gastroenterologists, and a patient representative reached unanimous consensus through an evidence-to-decision framework to select among multiple interventions, and a Delphi process to formulate the recommendation. The project was developed in an online authoring and publication platform (MAGICapp), and was overseen by an external auditor.
RESULTS
We suggest posterior partial fundoplication over total posterior or anterior 90° fundoplication in adult patients with GERD. We suggest anterior >90° fundoplication as an alternative, although relevant comparative evidence is limited (weak recommendation). The guideline, with recommendations, evidence summaries and decision aids in user friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/j20X4n.
CONCLUSION
This rapid guideline was developed in line with highest methodological standards and provides evidence-informed recommendations on the surgical management of GERD. It provides user-friendly decision aids to inform healthcare professionals' and patients' decision making.
Topics: Humans; GRADE Approach; Network Meta-Analysis; Gastroesophageal Reflux
PubMed: 36196591
DOI: 10.1002/ueg2.12318