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Nutrients May 2024(1) Background: Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. The aim of the study was to examine the existing published results of the... (Meta-Analysis)
Meta-Analysis Review
(1) Background: Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. The aim of the study was to examine the existing published results of the association between elevated serum phosphate concentrations and cardiovascular mortality, along with the CVD incidence and subclinical coronary atherosclerosis, in primary prevention among non-selected samples of the general population. (2) Methods: A systematic review and meta-analysis were carried out using literature obtained from PubMed, SCOPUS, and the Web Of Science until March 2024 and following the PRISMA guidelines. Relevant information was extracted and presented. Random and fixed effects models were used to estimate the pooled odds ratio (OR) and hazard ratio (HR) with their 95% coefficient interval (CI), and I was used to assess heterogeneity. (3) Results: Twenty-five studies met our inclusion criteria and were included in the meta-analysis (11 cross-sectional and 14 cohort studies). For cardiovascular mortality, which included 7 cohort studies and 41,764 adults, the pooled HR was 1.44 (95% CIs 1.28, 1.61; I 0%) when the highest versus the reference level of serum phosphate concentrations were compared. For CVDs, which included 8 cohort studies and 61,723 adults, the pooled HR was 1.12 (95% CIs 0.99, 1.27; I 51%). For subclinical coronary atherosclerosis, which included 11 cross-sectional studies and 24,820 adults, the pooled OR was 1.44 (95% CIs 1.15, 1.79; I 88%). (4) Conclusions: The highest serum phosphate concentrations were positively associated with a 44% increased risk of cardiovascular mortality and subclinical coronary atherosclerosis.
Topics: Humans; Coronary Artery Disease; Phosphates; Cardiovascular Diseases; Risk Factors; Female; Male; Incidence; Middle Aged; Adult
PubMed: 38892532
DOI: 10.3390/nu16111599 -
Nutrients May 2024Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D.... (Meta-Analysis)
Meta-Analysis Review
Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin D plays a key role as a hormone, which is supported by various enzymatic, physiological, metabolic, and pathophysiological processes related to various human organs and systems. Accruing evidence supports that vitamin D plays a key role in pancreatic islet dysfunction and insulin resistance in type 2 diabetes. From an epidemiological viewpoint, numerous studies suggest that the growing incidence of type 2 diabetes in humans may be linked to the global trend of prevalent vitamin D insufficiency. In the past, this association has raised discussions due to the equivocal results, which lately have been more convincing of the true role of vitamin D supplementation in the prevention of incident type 2 diabetes. Most meta-analyses evaluating this role have been conducted in adults or young older persons (50-60 years old), with only one focusing on older populations, even if this is the population at greater risk of both hypovitaminosis D and type 2 diabetes. Therefore, we conducted an update of the previous systematic review and meta-analysis examining whether hypovitaminosis D (low serum 25OHD levels) can predict incident diabetes in prospective longitudinal studies among older adults. We found that low 25OHD was associated with incident diabetes in older adults even after adjusting for several relevant potential confounders, confirming and updating the results of the only previous meta-analysis conducted in 2017.
Topics: Humans; Diabetes Mellitus, Type 2; Vitamin D; Vitamin D Deficiency; Aged; Incidence; Risk Factors; Middle Aged; Male; Female
PubMed: 38892495
DOI: 10.3390/nu16111561 -
European Journal of Medical Research Jun 2024Adverse drug events (ADEs) represent challenges affecting Africa's healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs. (Review)
Review
BACKGROUND
Adverse drug events (ADEs) represent challenges affecting Africa's healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs.
OBJECTIVES
We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa.
METHODS
Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095).
RESULTS
We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2-21.4%) and 74.2% (IQR: 54.1-90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5-9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6-56.1%) and 32.6% (IQR: 26.0-41.3%), respectively, with a median of 43.5% (IQR: 16.3-59.0%) and 12.4% (IQR: 7.1-28.1%) of ADEs being preventable in general and specific patients, respectively.
CONCLUSIONS
The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.
Topics: Humans; Africa; Drug-Related Side Effects and Adverse Reactions; Hospitalization; Prevalence
PubMed: 38880895
DOI: 10.1186/s40001-024-01934-0 -
BMJ Mental Health Jun 2024To describe the pattern of the prevalence of mental health problems during the first year of the COVID-19 pandemic and examine the impact of containment measures on... (Meta-Analysis)
Meta-Analysis
AIM
To describe the pattern of the prevalence of mental health problems during the first year of the COVID-19 pandemic and examine the impact of containment measures on these trends.
METHODS
We identified articles published until 30 August 2021 that reported the prevalence of mental health problems in the general population at two or more time points. A crowd of 114 reviewers extracted data on prevalence, study and participant characteristics. We collected information on the number of days since the first SARS-CoV-2 infection in the study country, the stringency of containment measures and the number of cases and deaths. We synthesised changes in prevalence during the pandemic using a random-effects model. We used dose-response meta-analysis to evaluate the trajectory of the changes in mental health problems.
RESULTS
We included 41 studies for 7 mental health conditions. The average odds of symptoms increased during the pandemic (mean OR ranging from 1.23 to 2.08). Heterogeneity was very large and could not be explained by differences in participants or study characteristics. Average odds of psychological distress, depression and anxiety increased during the first 2 months of the pandemic, with increased stringency of the measures, reported infections and deaths. The confidence in the evidence was low to very low.
CONCLUSIONS
We observed an initial increase in the average risk of psychological distress, depression-related and anxiety-related problems during the first 2 months of the pandemic. However, large heterogeneity suggests that different populations had different responses to the challenges imposed by the pandemic.
Topics: Humans; COVID-19; Prevalence; Mental Disorders; SARS-CoV-2; Pandemics; Anxiety; Mental Health; Depression
PubMed: 38876492
DOI: 10.1136/bmjment-2024-301018 -
Eastern Mediterranean Health Journal =... May 2024The increasing emergencies and humanitarian challenges have worsened the mental health condition of women in the Eastern Mediterranean Region. (Review)
Review
BACKGROUND
The increasing emergencies and humanitarian challenges have worsened the mental health condition of women in the Eastern Mediterranean Region.
AIM
To assess the prevalence, determinants and interventions to address mental health among women in fragile and humanitarian settings in the Eastern Mediterranean Region.
METHODS
Using the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, we reviewed 59 peer-reviewed published studies (PubMed, IMEMR) and grey literature (WHO/IRIS) from January 2001 to February 2023, focusing on women's mental health in the Eastern Mediterranean Region. We then conducted a descriptive analysis of the sociodemographic characteristics.
RESULTS
Among the 59 studies reviewed, only 13 of the 48 peer-reviewed studies focused primarily on women's mental health, 11 grey literature records mostly presented grouped regional data, 11 of the 25 studies on mental health among migrants were about those taking refuge in high-income countries. The average prevalence of mental disorders from 32 cross-sectional studies on women aged 12-75 years was 49%, average prevalence of anxiety was 68%, post-traumatic stress disorder was 52%, and depression was 43%. Women exhibited higher level depression than men. Age, educational disparities, and limited access to services were important risk factors for mental health disorder. Several promising interventions emerged.
CONCLUSION
More efforts should be made to provide customized, context-specific solutions to the mental health challenges of women in humanitarian and fragile settings in the Eastern Mediterranean Region, including allocation of more resources to mental health programmes, addressing barriers, enhancing mental health surveillance, and reduction of stigma.
Topics: Adolescent; Adult; Aged; Female; Humans; Middle Aged; Young Adult; Mediterranean Region; Mental Disorders; Mental Health; Middle East; Prevalence; Women's Health
PubMed: 38874297
DOI: 10.26719/2024.30.5.369 -
Journal of the American Heart... Jun 2024Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the standard treatment for SVASD, data on outcomes have been confined to small cohorts. Thus, we conducted a systematic review of the outcomes of SVASD repair.
METHODS AND RESULTS
The primary outcome was death. Secondary outcomes encompassed atrial fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular accident, reoperation, residual septal defect, superior vena cava obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences of outcomes were calculated using a random-effects model. Forty studies involving 1320 patients who underwent SVASD repair were included. The majority were male patients (55.4%), with 88.0% presenting with associated anomalous pulmonary venous connection. The weighted mean age was 18.6±12.5 years, and the overall weighted mean follow-up period was 8.6±10.4 years. The in-hospital mortality rate was 0.24%, with a 30-day mortality rate of 0.5% reported in 780 patients. Incidences of atrial fibrillation, sinus node dysfunction, pacemaker insertion, and cerebrovascular accident over the long-term follow-up were 3.3% (2.18%-4.93%), 6.5% (5.09%-8.2%), 2.23% (1.34%-3.57%), and 2.03% (0.89%-2.46%) respectively. Reoperation occurred in 1.36% (0.68%-2.42%) of surgeries, residual septal defect in 1.34% (0.69%-2.42%), superior vena cava obstruction in 1.76% (1.02%-2.9%), and reimplanted pulmonary vein obstruction in 1.4% (0.7%-2.49%).
CONCLUSIONS
This is the first comprehensive analysis of outcomes following surgical repair of SVASD. The findings affirm the safety and effectiveness of surgery, establishing a reference point for evaluating emerging transcatheter therapies. Safety and efficacy profiles comparable to surgical repair are essential for widespread adoption of transcatheter treatments.
Topics: Humans; Heart Septal Defects, Atrial; Treatment Outcome; Cardiac Surgical Procedures; Postoperative Complications; Male; Adolescent; Young Adult; Female; Child; Hospital Mortality; Adult
PubMed: 38874063
DOI: 10.1161/JAHA.123.033686 -
Frontiers in Endocrinology 2024Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving patient outcomes. However, data on the prevalence and factors associated with unmet drug-related needs in patients with diabetes in Ethiopia is limited. This systematic review and meta-analysis aims to provide a comprehensive analysis of the prevalence of unmet drug-related needs among patients with diabetes mellitus in Ethiopia.
METHODS
A thorough exploration of databases, including PubMed, Scopus, Hinari, and Embase and Google Scholar, was conducted to identify pertinent studies. Inclusion criteria involved observational studies that reported the prevalence of unmet drug-related needs in Ethiopian patients with diabetes. The quality of the studies was assessed using Joanna Briggs Institute (JBI) checklists. A random-effects meta-analysis was employed to amalgamate data on study characteristics and prevalence estimates, followed by subsequent subgroup and sensitivity analyses. Graphical and statistical assessments were employed to evaluate publication bias.
RESULTS
Analysis of twelve studies involving 4,017 patients revealed a pooled prevalence of unmet drug-related needs at 74% (95% CI 63-83%). On average, each patient had 1.45 unmet drug-related needs. The most prevalent type of unmet need was ineffective drug therapy, 35% (95% CI 20-50). Type 2 diabetes, retrospective study designs, and studies from the Harari Region were associated with a higher prevalence. Frequently reported factors associated with the unmet drug-related needs includes multiple comorbidities, older age, and polypharmacy. Notably, the results indicated significant heterogeneity (I = 99.0%; p value < 0.001), and Egger's regression test revealed publication bias with p<0.001.
CONCLUSION
The prevalence of unmet drug-related needs among diabetes patients with diabetes in Ethiopia is high with the most prevalent issue being ineffective drug therapy. Targeted interventions are needed; especially patients on multiple medications, advanced age, with comorbidities, and prolonged illness duration to improve diabetes management and outcomes.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero, identifier CRD42024501096.
Topics: Humans; Ethiopia; Diabetes Mellitus; Hypoglycemic Agents; Health Services Needs and Demand; Prevalence; Diabetes Mellitus, Type 2
PubMed: 38872966
DOI: 10.3389/fendo.2024.1399944 -
Journal of Infection and Public Health Jul 2024The objective of this were conducted to elucidate spatiotemporal variations in malaria epidemiology in Gabon since 1980. For that, five databases, were used to collect... (Meta-Analysis)
Meta-Analysis Review
The objective of this were conducted to elucidate spatiotemporal variations in malaria epidemiology in Gabon since 1980. For that, five databases, were used to collect and identify all studies published between 1980 and 2023 on malaria prevalence, antimalarial drug resistance, markers of antimalarial drug resistance and insecticide resistance marker. The findings suggest that Gabon continues to face malaria as an urgent public health problem, with persistently high prevalence rates. Markers of resistance to CQ persist despite its withdrawal, and markers of resistance to SP have emerged with a high frequency, reaching 100 %, while ACTs remain effective. Also, recent studies have identified markers of resistance to the insecticides Kdr-w and Kdr-e at frequencies ranging from 25 % to 100 %. Ace1R mutation was reported with a frequency of 0.4 %. In conclusion, the efficacy of ACTs remains above the threshold recommended by the WHO. Organo-phosphates and carbamates could provide an alternative for vector control.
Topics: Gabon; Humans; Malaria; Prevalence; Antimalarials; Insecticide Resistance; Drug Resistance; Animals; Insecticides
PubMed: 38870682
DOI: 10.1016/j.jiph.2024.05.047 -
PloS One 2024Poor attachment, suckling, and positioning contribute to ineffective breastfeeding techniques. Poor weight gain, stunting, and decreased immunity are caused by... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Poor attachment, suckling, and positioning contribute to ineffective breastfeeding techniques. Poor weight gain, stunting, and decreased immunity are caused by insufficient breast milk intake owing to ineffective breastfeeding techniques. Numerous primary studies conducted in Ethiopia have revealed negative effects of ineffective breastfeeding techniques. However, inconsistencies have been observed among these studies, and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and factors associated with ineffective breastfeeding techniques in Ethiopia.
METHODS
Using PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar to investigate the prevalence and associated factors of ineffective breastfeeding techniques. Q and I2 tests were used to assess heterogeneity across studies. To evaluate the national prevalence and effect size of the linked covariates, a weighted inverse variance random-effects model was used. Subgroup analysis was performed based on the region, sample size, and year of publication. Funnel plots and Egger's regression tests were used to examine publication bias. A sensitivity analysis was also performed to determine the impact of the studies.
RESULTS
The analysis included a total of eleven studies with 4,470 participants used in the analysis. The pooled prevalence of ineffective breastfeeding techniques in Ethiopia was 53.13% (45.49, 60.78) no formal education (AOR = 3.42; 95% CI:1.67-5.18; I2 = 72.2%; P = 0.0132), primipara (AOR = 2.72;95% CI:1.81-3.64; I2 = 46.7%; P = 0.131), postnatal care (PNC) (AOR = 1.84; 95% CI:1.35-2.32; I2 = 0%; P = 0.53), breastfeeding counseling (AOR = 1.93; 95% CI:1.23-2.63; I2 = 0%;P = 0.35), home delivery and having breast problem (AOR = 3.11; 95% CI:1.09-5.16; I2 = 0%;P = 0.877) and (AOR = 2.22; 95% CI:1.28-3.16; I2 = 0%;P = 0.80) respectively were significantly associated with ineffective breastfeeding techniques.
CONCLUSION
The prevalence of ineffective breastfeeding techniques in Ethiopia remains high. Policymakers and program officials should focus on empowering women, increasing institutional delivery, and providing counseling on breastfeeding throughout the maternal continuum of care. These measures will improve breastfeeding techniques and lead to better health of both infants and women.
Topics: Breast Feeding; Ethiopia; Humans; Female; Prevalence; Mothers
PubMed: 38870174
DOI: 10.1371/journal.pone.0303749 -
PloS One 2024Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite numerous primary studies have been conducted to determine the prevalence of uncontrolled hypertension and identify its associated factors among hypertensive patients in Sub-Saharan Africa, these studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of uncontrolled hypertension and identify its associated factors.
METHODS
We have searched PubMed, Google Scholar, and Web of Science databases extensively for all relevant studies. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to compute the overall pooled prevalence of uncontrolled hypertension and the effect size of its associated factors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test.
RESULTS
A total of twenty-six primary studies with a sample size of 11,600 participants were included in the final meta-analysis. The pooled prevalence of uncontrolled hypertension was 50.29% (95% CI: 41.88, 58.69; I2 = 98.98%; P<0.001). Age of the patient [AOR = 1.57: 95% CI: 1.004, 2.44], duration of diagnosis [AOR = 2.57: 95% CI: 1.18, 5.57], non-adherence to physical activity [AOR = 2.13: 95% CI: 1.15, 3.95], khat chewing [AOR = 3.83: 95% CI: 1.59, 9.24] and habitual coffee consumption [AOR = 10.79: 95% CI: 1.84, 63.24] were significantly associated with uncontrolled hypertension among hypertensive patients.
CONCLUSIONS
The pooled prevalence of uncontrolled hypertension was considerably high. Older age, duration of diagnosis, non-adherence to physical activity, khat chewing and habitual coffee consumption were independent predictors of uncontrolled hypertension. Therefore, health professionals and other responsible stakeholders should encourage hypertensive patients to adhere to regular physical activity, and abstain from khat chewing and habitual coffee consumption. Early identification of hypertension and management of comorbidities is crucial, and it should be emphasized to control hypertension easily.
Topics: Hypertension; Humans; Africa South of the Sahara; Prevalence; Risk Factors
PubMed: 38870163
DOI: 10.1371/journal.pone.0301547