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BMC Public Health Mar 2024Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors.
OBJECTIVE
To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa.
METHOD
Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg's Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size.
RESULT
A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26-45%). Good knowledge (OR = 1.6, 95%CI; 1.43-1.8), positive attitude (OR = 2.54, 95% CI; 2.13-3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03-1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03-3.31), middle wealth index (OR = 1.33, 95%CI; 1.04-1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68-0.98), availability of promotion (OR = 2.53, 95%CI: 1.51-4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9-8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02-2.12) and family support (OR = 4.3, 95% CI; 2.98-6.21) were the significant factors for the uptake of human papilloma virus vaccine.
CONCLUSION
As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother's educational status, mother's occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.
Topics: Female; Humans; Africa, Eastern; Cross-Sectional Studies; Papillomavirus Infections; Papillomavirus Vaccines; Uterine Cervical Neoplasms; Vaccination
PubMed: 38500046
DOI: 10.1186/s12889-024-18141-5 -
Scientific Reports Mar 2024Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity,... (Meta-Analysis)
Meta-Analysis
Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity, especially in Sub-Saharan Africa: The main aim of this systematic review and meta-analysis was to estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa. We searched PubMed, Web of Science, Google Scholar, Research Gate, and institutional repositories for papers that reported the proportion of malnutrition among children with cerebral palsy that were published between December 2010 and September 2023. Data were retrieved using the standardized JBI data extraction checklist through Microsoft Excel, and then exported to STATA 17 for further analysis. DerSimonian and Laird's estimator was used to calculate the pooled effect size in the random-effects model. Statistics such as the Cochran Q test and I2 test were employed to measure heterogeneity. Egger's test and the funnel plot were used to look for publication bias. This systematic review and meta-analysis used 16 studies from Sub-Saharan Africa to estimate the proportion of malnutrition among 2,120 children with cerebral palsy. The pooled proportion of malnutrition among children with cerebral palsy in Sub-Saharan Africa by using random-effects model analysis was found to be 59.7% (95% CI; 49.8-69.6). The proportion of malnutrition was also estimated by sample sizes categorized as ≤ 120 and > 120, and the proportion of malnutrition was found to be 54.0 (95% CI: 44.7-63.3) and 64.5 (95% CI: 50.5-78.5). Moreover, the proportion of malnutrition was estimated by accounting for the difference in the year of publication. In this regard, the study classified before ≤ 2017 and > 2017, and the proportion of malnutrition was found to be 53.7 (95% CI: 38.0-69.3) and 62.5 (95% CI: 49.7-75.3) in Sub-Saharan Africa respectively. Malnutrition among children with cerebral in Sub-Saharan Africa was found to be very high. Hence, enhancing and developing strategic guidelines for malnutrition screening, prevention, and nutritional support are crucial among children with cerebral palsy. Furthermore, systematic review, randomized control trials, and qualitative studies are recommended to understand the burden more among children with cerebral palsy in the continent.
Topics: Child; Humans; Cerebral Palsy; Africa South of the Sahara; Comorbidity; Malnutrition; Prevalence
PubMed: 38499717
DOI: 10.1038/s41598-024-55730-1 -
BMC Pediatrics Mar 2024The impact of vitamin D on type 1 diabetes has been a controversial topic in public health. Furthermore, significant differences in the proportion of vitamin D have been... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The impact of vitamin D on type 1 diabetes has been a controversial topic in public health. Furthermore, significant differences in the proportion of vitamin D have been noted. The purpose of this systematic review was to determine the overall proportion of vitamin D deficiency in children/adolescents with type 1 diabetes (T1D).
METHODS
Based on six electronic databases (PubMed, Web of Science, Embase, Ovid Medline, ProQuest, and Cochrane Library), eligible studies since the databases' inception up to April 2022 were searched. Reference lists were also manually searched to identify additional studies. Overall, studies with statistical information on vitamin D deficiency in children and adolescents with T1D were included, and a random effects model was applied for the meta-analysis. In addition, subgroup and sensitivity analyses were carried out to evaluate heterogeneity, and publication bias was evaluated by using Egger's test.
RESULTS
A total of 45 studies involving 6,995 participants met the inclusion criteria; these included 25 countries covering Africa, Oceania, Europe, North America and Asia. The proportion of vitamin D deficiency in children/adolescents with T1D was 45% (95% confidence interval [CI] 37-54%, I = 97.94%). Subgroup analysis further revealed that the publication year, study design, vitamin D classification, season and geographical region significantly contributed to the variation in the reported incidence of vitamin D deficiency.
CONCLUSIONS
The results of the meta-analysis showed that the proportion of vitamin D deficiency among T1D children/adolescents was 45%. In addition, the proportion remains higher, which has important implications for adapting health and social care systems.
Topics: Child; Humans; Adolescent; Diabetes Mellitus, Type 1; Vitamins; Vitamin D; Vitamin D Deficiency; Research Design
PubMed: 38493103
DOI: 10.1186/s12887-024-04683-5 -
Journal of Pediatric Health Care :... Mar 2024Nonimmersive virtual reality (NIVR), a computer-generated virtual reality experience wherein users are not fully immersed, has been increasingly used in pediatric...
INTRODUCTION
Nonimmersive virtual reality (NIVR), a computer-generated virtual reality experience wherein users are not fully immersed, has been increasingly used in pediatric healthcare. This study aimed to identify the effects of NIVR-based interventions for children.
METHOD
A mixed methods systematic review of relevant studies published until December 2023 was conducted. We included samples of healthy children and those with chronic conditions or disabilities, findings related to self-management or social skills, and the NIVR interventions applied. A convergent-integrated design was used for the synthesis.
RESULTS
This review included 22 studies, of which 15 examined children having autism spectrum disorders. Utilizing NIVR was found to be effective in enhancing social skills. Participating in virtual communities with peers having similar conditions was determined to facilitate social support and identity exploration.
DISCUSSION
Healthcare interventions using NIVR need to be explored further to improve self-management and social skills in children with various conditions.
PubMed: 38466243
DOI: 10.1016/j.pedhc.2024.01.008 -
Frontiers in Pediatrics 2024Asthma is a chronic condition that affects millions of adolescents and young adults (AYA) worldwide. The transition from pediatric to adult care presents unique... (Review)
Review
INTRODUCTION
Asthma is a chronic condition that affects millions of adolescents and young adults (AYA) worldwide. The transition from pediatric to adult care presents unique challenges for this population, affecting their self-management, quality of life and overall health outcomes. This systematic review aims to consolidate the available evidence on challenges encountered by AYA with asthma during the transition period from child to AYA and on the key elements of transitional care for AYAs with asthma including the outcomes achieved, ultimately enhancing outcomes.
METHODOLOGY
A systematic literature search was performed in PubMed, Embase, Medline, Scopus, and Web of Science from their inception to October 2, 2023, to provide an overview of currently available literature. Primary quantitative and qualitative studies, published in peer-reviewed journals that focused on AYA with a confirmed diagnosis of asthma were considered if they focused on challenges encountered by AYA with asthma during the transition process and/or components of transitional care and their outcomes assessed.
RESULTS
A total of 855 studies were initially identified and 6 articles were included in this systematic literature review. Several challenges experienced by AYA with asthma were identified including maintaining medication adherence, the need to take responsibility and being involved, understanding their condition and its severity, feeling left out of the care system, and experiencing a lack of engagement. The identified transitional care components included a standardized form for medical data transmission, a joint consultation and to offer several longer consultations.
CONCLUSION
Several international guidelines for asthma care recommend implementing transition programs in the care for AYA with asthma. Such transition programs should include a comprehensive and individualized approach addressing several challenges faced, to ensure optimal outcomes post-transition. However, to date, data on effective components of transitional care facilitating good outcomes were found to be limited. This systematic review underscores the need for larger studies evaluating the effect of the components of transition programs.
PubMed: 38450298
DOI: 10.3389/fped.2024.1348963 -
BMJ Global Health Feb 2024Limited information on costs and the cost-effectiveness of hospital interventions to reduce antibiotic resistance (ABR) hinder efficient resource allocation.
Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review.
INTRODUCTION
Limited information on costs and the cost-effectiveness of hospital interventions to reduce antibiotic resistance (ABR) hinder efficient resource allocation.
METHODS
We conducted a systematic literature review for studies evaluating the costs and cost-effectiveness of pharmaceutical and non-pharmaceutical interventions aimed at reducing, monitoring and controlling ABR in patients. Articles published until 12 December 2023 were explored using EconLit, EMBASE and PubMed. We focused on critical or high-priority bacteria, as defined by the WHO, and intervention costs and incremental cost-effectiveness ratio (ICER). Following Preferred Reporting Items for Systematic review and Meta-Analysis guidelines, we extracted unit costs, ICERs and essential study information including country, intervention, bacteria-drug combination, discount rates, type of model and outcomes. Costs were reported in 2022 US dollars ($), adopting the healthcare system perspective. Country willingness-to-pay (WTP) thresholds from Woods 2016 guided cost-effectiveness assessments. We assessed the studies reporting checklist using Drummond's method.
RESULTS
Among 20 958 articles, 59 (32 pharmaceutical and 27 non-pharmaceutical interventions) met the inclusion criteria. Non-pharmaceutical interventions, such as hygiene measures, had unit costs as low as $1 per patient, contrasting with generally higher pharmaceutical intervention costs. Several studies found that linezolid-based treatments for methicillin-resistant were cost-effective compared with vancomycin (ICER up to $21 488 per treatment success, all 16 studies' ICERs
CONCLUSION
Robust information on ABR interventions is critical for efficient resource allocation. We highlight cost-effective strategies for mitigating ABR in hospitals, emphasising substantial knowledge gaps, especially in low-income and middle-income countries. Our study serves as a resource for guiding future cost-effectiveness study design and analyses. CRD42020341827 and CRD42022340064.
Topics: Humans; Methicillin-Resistant Staphylococcus aureus; Checklist; Drug Resistance, Microbial; Hospitals; Pharmaceutical Preparations
PubMed: 38423548
DOI: 10.1136/bmjgh-2023-013205 -
Archives of Medical Science : AMS 2024Timely and effective treatments of pericoronitis are very important. We aimed to evaluate the role of ornidazole in the treatment of pericoronitis, to provide insights... (Review)
Review
INTRODUCTION
Timely and effective treatments of pericoronitis are very important. We aimed to evaluate the role of ornidazole in the treatment of pericoronitis, to provide insights for clinical pericoronitis treatment.
MATERIAL AND METHODS
The PubMed, Clinical trials, EMBASE, Science Direct, Cochrane Library, China National Knowledge Infrastructure (CNKI), Weipu and Wanfang databases were searched to find randomized controlled trials (RCTs) of ornidazole in the treatment of pericoronitis from the establishment of the database to March 15, 2023. Review Manager 5.3 software was used for meta-analysis.
RESULTS
A total of 16 RCTs involving 2004 patients were included. The results of the meta-analysis showed that the effective rate of ornidazole treatment was significantly higher than that of the routine treatment group (RR = 1.22, 95% CI (1.15, 1.29), < 0.001). Ornidazole treatment was beneficial to reduce the oral bacterial density (MD = -26.13, 95% CI (-32.08, -21.51)), time to pain disappearance (MD = -0.64, 95% CI (-0.92, -0.17)) and time to disappearance of redness and swelling of the teeth crown (MD = -1.45, 95% CI (-2.43, -1.01)) compared to the routine treatment (all = 0.05). No publication bias was found by the funnel plots and Egger test ( = 0.206).
CONCLUSIONS
Ornidazole is effective in the treatment of pericoronitis, with more advantages. Still, the effects and safety of ornidazole in the treatment of pericoronitis need to be evaluated by more high-quality RCTs with larger sample sizes.
PubMed: 38414462
DOI: 10.5114/aoms/171907 -
International Journal of Nursing... Jan 2024During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students'...
INTRODUCTION
During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students' experiences of teaching and learning during the COVID-19 pandemic.
CONTENT
A meta-synthesis of qualitative articles were conducted. Three online databases were searched from December 2019 to December 2022. Qualitative studies and qualitative sections of mixed method studies were included.
SUMMARY
Twenty-four qualitative studies and seven mixed-method studies were included in the review. The findings consisted of one main theme "educational transformation", and three categories "challenging face-to-face clinical training", "transition from face-to-face to virtual education", and "support continua". The evidence indicated that during this health-related crisis, most of the training was provided as distance learning in various forms. According to the findings, distance education alone cannot replace face-to-face education and is suggested to be considered as a supplementary learning method.
OUTLOOK
This study provides a comprehensive understanding of nursing students' experiences during the COVID-19 pandemic, offering practical implications for educators and institutions globally. The lessons learned can inform strategic decisions, policies, and practices to enhance the resilience and adaptability of nursing education in the face of unforeseen challenges.
Topics: Humans; Pandemics; Students, Nursing; COVID-19; Educational Status; Education, Distance
PubMed: 38407250
DOI: 10.1515/ijnes-2023-0094 -
Therapeutics and Clinical Risk... 2024Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children's daily activities. As a technology that... (Review)
Review
Effectivity of Virtual Reality to Improve Balance, Motor Function, Activities of Daily Living, and Upper Limb Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.
BACKGROUND
Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children's daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients' quality of life, especially in a safe, enjoyable, and playful environment.
PURPOSE
This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP.
METHODS
We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2.
RESULTS
Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function.
CONCLUSION
With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.
PubMed: 38375076
DOI: 10.2147/TCRM.S432249 -
Frontiers in Pediatrics 2024The impact of climate change on ambient temperatures threatens to worsen pediatric pneumonia-related outcomes considerably. This study examined the associations of... (Review)
Review
INTRODUCTION
The impact of climate change on ambient temperatures threatens to worsen pediatric pneumonia-related outcomes considerably. This study examined the associations of temperature variation and extreme temperature with pediatric pneumonia-related events using a meta-analysis.
METHODS
We systematically searched PubMed, Medline, Embase, and Web of Science databases for relevant literature, and the quality of evidence was assessed. Fixed and random-effects meta-analyses were performed to calculate the pooled relative risks (RRs) of the associations with pneumonia-related events.
RESULTS
We observed that a 1°C temperature variation increased the RR of pneumonia events by 1.06-fold (95% confidence interval (CI): 1.03-1.10). A 1°C temperature variation increased the RR by 1.10-fold of the pediatric pneumonia hospital admissions (95% CI: 1.00-1.21) and 1.06-fold of the pediatric pneumonia emergency department visits (95% CI: 1.01-1.10). Extreme cold increased the RR by 1.25-fold of the pediatric pneumonia events (95% CI: 1.07-1.45). A 1°C temperature variation increased the RR of pneumonia events in children by 1.19-fold (95% CI: 1.08-1.32), girls by 1.03-fold (95% CI: 1.02-1.05), and in temperate climate zones by 1.07-fold (95% CI: 1.03-1.11). Moreover, an increase in extreme cold increased the RR of pneumonia events in children by 2.43-fold (95% CI: 1.72-3.43), girls by 1.96-fold (95% CI: 1.29-2.98) and in temperate climate zones by 2.76-fold (95% CI: 1.71-4.47).
CONCLUSION
Our study demonstrated that pediatric pneumonia events are more prevalent among children, particularly girls, and individuals residing in temperate climate zones. Climate change represents an emergent public health threat, affecting pediatric pneumonia treatment and prevention..
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42022378610).
PubMed: 38370139
DOI: 10.3389/fped.2024.1329918