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The outcome of COVID-19 among the geriatric age group in African countries: protocol for a systematic review and meta-analysis.

ABSTRACT: Background:According to the World Health Organization (WHO), the outbreak of coronavirus disease in 2019 (COVID-19) has been declared as a pandemic and public health emergency that infected more than 5 million people worldwide at the time of writing this protocol. Strong evidence for the outcome of COVID-19 among the geriatric age group has not been published in Africa. Therefore, this protocol will be served as a guideline to conduct a systematic review and meta-analysis of the outcome of COVID-19 among the geriatric age group in Africa. Methods:Published and unpublished studies on the outcome of COVID-19 among the geriatric age group in Africa and written in any language will be included. Databases (PubMed / MEDLINE, Google Scholar, Google, EMBASE, Web of Science, Microsoft Academic, WHO COVID-19 database, Cochran Library, Africa Wide Knowledge, and Africa Index Medicus) from March to August 2020 will be searched. Two independent reviewers will select, screen, extract data, and assess the risk of bias. The proportion will be measured using a random-effects model. Subgroup analysis will be conducted to manage heterogeneity. The presence of publication bias will be assessed using Egger's test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported per the PRISMA-P guidelines. Conclusion:This systematic review and meta-analysis protocol will be expected to quantify the outcome of COVID-19 among the geriatric age group in Africa. Systematic review registration:This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) in April 2020 and accepted with the registration number: (https://www.crd.york.ac.uk/PROSPERO). CRD42020180600.

SUBMITTER: Tadesse DB

PROVIDER: S-EPMC7541940 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The outcome of COVID-19 among the geriatric age group in African countries: protocol for a systematic review and meta-analysis.

Tadesse Degena Bahrey DB Wahdey Shishay S Negash Melaku M Ayele Ebud E Haile Teklehaimanot Gereziher TG Kiros Kbrom Gemechu KG Tesfamichael Yohannes Ashebir YA Gebrekidan Kiros Belay KB

Asthma research and practice 20201008

<h4>Background</h4>According to the World Health Organization (WHO), the outbreak of coronavirus disease in 2019 (COVID-19) has been declared as a pandemic and public health emergency that infected more than 5 million people worldwide at the time of writing this protocol. Strong evidence for the outcome of COVID-19 among the geriatric age group has not been published in Africa. Therefore, this protocol will be served as a guideline to conduct a systematic review and meta-analysis of the outcome ...[more]

PMID: 33047071

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Project description:BackgroundObstetric fistula among women of reproductive age is a significant public health issue in developing countries, including Sub-Saharan Africa. However, the pooled awareness of obstetric fistula among women of reproductive age in Sub-Saharan Africa and its variation between countries have not yet been studied. Hence, the review aims to assess variability and awareness of obstetric fistula among women of reproductive age in Sub-Saharan African Countries.MethodArticles were searched using different electronic databases, such as PubMed, Web of science, science direct (Scopus), Google scholar, and HINARI and manual search without regard to publication date. A random-effects model was used to ascertain the pooled prevalence of obstetric fistula awareness among women of reproductive age in Sub-Saharan Africa. Publication bias was checked by using funnel plot and Egger's test at a 5% level of significance. I2 test statistics was performed to evaluate heterogeneity among included studies. In addition, to identify the possible reason for the potential heterogeneity between the studies, sub-group and meta-regression analyses were conducted. A sensitivity analysis was performed to determine the impact of individual research on the overall results. The data were extracted by using Microsoft excel and analyzed using statistical software STATA/SE version 17.ResultA total of 22 studies with 79,693 women of reproductive age were included in this systematic review and meta-analyses. In Sub-Saharan Africa, the pooled prevalence of awareness towards obstetric fistula among women of reproductive age was 40.85% (95% CI: 33.48, 48.22%). Analysis of the subgroups by specific countries revealed significant variation. The highest awareness of obstetric fistula was found among Tanzanian women of reproductive age (61.10%, 95% CI: 55.87-66.33%), whereas the lowest awareness was found in research from the Gambia (12.80%, 95% CI: 12.20-13.40%).The likelihood of obstetric fistula awareness were lower by a factor of 0.424 among studies with sample sizes greater than 3542 (β = -0.424 (95% CI: -0.767 to 0.081), p -value <0.05).ConclusionAccording to the current review, there is a low level of awareness about obstetric fistula among women of reproductive age in sub-Saharan Africa, and the results of the sub-group analysis by country showed wide variations. Therefore, we emphasize the need for country-specific public health initiatives to raise awareness about obstetric fistula among women of reproductive age, which could reduce the risk of delayed treatment.

Project description:BackgroundAdvances in medical science coupled with increased people's income results an elevated average of life expectancy even in the resource poor countries. The growing number of aged population, however, has drawn little attention in health system discourse of low- and Middle-Income Countries (LMICs). Nevertheless, ensuring availability of appropriate service and properly trained and skilled health workforce is an absolute necessity for a functional geriatric and palliative healthcare. Given the lack of specialist geriatricians in LMICs contexts, there are other health workforce strategies that might be effective in building a proper health system response to this growing demand. Therefore, we aimed to identify and synthesize evidence on the existing health workforce-related strategies taken to provide geriatric and palliative care in LMICs.MethodsWe will follow the recommendations provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Following the PRISMA guidelines, we will search the Medline/PubMed, Scopus, Web of Science and Cochrane database from January 2011 to December 2021 using a comprehensive search strategy. Two independent reviewers will screen the title and abstracts text using the specified inclusion and exclusion criteria. For the finally included articles, full manuscripts will be retrieved, and reviewers will appraise and extract data using standardized form independently. The third reviewer will resolve any disagreements appear in the process. The findings of the review be synthesized using the narrative synthesis approach to analyse descriptive quantitative and qualitative data. Furthermore, meta-analysis will be done provided that the data meet certain requirement as per Cochrane guideline. Rayyan software will be used to manage and synthesize data. Revman software will be used to do meta-analysis, if data support.ResultsFindings of this review will be published in a peer-reviewed journal.ConclusionThis systematic review will identify the existing effective strategies taken to provide geriatric and palliative care, in LMICs.

Project description:BackgroundCOVID 19 is the most recent cause of Adult respiratory distress syndrome ARDS. Invasive mechanical ventilation IMV can support gas exchange in patients failing non-invasive ventilation, but its reported outcome is highly variable between countries. We conducted a systematic review and meta-analysis on IMV for COVID-associated ARDS to study its outcome among different countries.MethodsCENTRAL, MEDLINE/PubMed, Cochrane Library, and Scopus were systematically searched up to August 8, 2020. Studies reporting five or more patients with end point outcome for severe COVID 19 infection treated with IMV were included. The main outcome assessed was mortality. Baseline, procedural, outcome, and validity data were systematically appraised and pooled with random-effect methods. Subgroup analysis for different countries was performed. Meta-regression for the effect of study timing and patient age and were tested. Publication bias was examined. This trial was registered with PROSPERO under registration number CRD42020190365.FindingsOur electronic search retrieved 4770 citations, 103 of which were selected for full-text review. Twenty-one studies with a combined population of 37359 patients with COVID-19 fulfilled the inclusion criteria. From this population, 5800 patients were treated by invasive mechanical ventilation. Out of those, 3301 patients reached an endpoint of ICU discharge or death after invasive mechanical ventilation while the rest were still in the ICU. Mortality from IMV was highly variable among the included studies ranging between 21% and 100%. Random-effect pooled estimates suggested an overall in-hospital mortality risk ratio of 0.70 (95% confidence interval 0.608 to 0.797; I2 = 98%). Subgroup analysis according to country of origin showed homogeneity in the 8 Chinese studies with high pooled mortality risk ratio of 0.97 (I2 = 24%, p = 0.23) (95% CI = 0.94-1.00), similar to Italy with a low pooled mortality risk ratio of 0.26 (95% CI 0.08-0.43) with homogeneity (p = 0.86) while the later larger studies coming from the USA showed pooled estimate mortality risk ratio of 0.60 (95% CI 0.43-0.76) with persistent heterogeneity (I2 = 98%, p<0.001). Meta-regression showed that outcome from IMV improved with time (p<0.001). Age had no statistically significant effect on mortality (p = 0.102). Publication bias was excluded by visualizing the funnel plot of standard error, Egger's test with p = 0.714 and Begg&Mazumdar test with p = 0.334.InterpretationThe study included the largest number of patients with outcome findings of IMV in this current pandemic. Our findings showed that the use of IMV for selected COVID 19 patients with severe ARDS carries a high mortality, but outcome has improved over the last few months and in more recent studies. The results should encourage physicians to use this facility when indicated for severely ill COVID-19 patients.

Dataset Information

The outcome of COVID-19 among the geriatric age group in African countries: protocol for a systematic review and meta-analysis.

Publications

The outcome of COVID-19 among the geriatric age group in African countries: protocol for a systematic review and meta-analysis.

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