Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is hig... more Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is high, particularly in sub-Saharan Africa. This study aimed to compare mortality and predictors of mortality in those who were antiretroviral therapy (ART) naïve to those with prior ART exposure.This retrospective cohort study was conducted in Serowe/Palapye District, Botswana, a predominantly urban district with a large burden of HIV-associated TB with a high case fatality. Between January 1, 2013 and December 31, 2013, patients confirmed with HIV-associated TB were enrolled and followed up. Kaplan-Meier and Cox proportional hazard modeling was undertaken to identify predictors of mortality, with ART initiation included as time-updated variable.Among the 300 patients enrolled in the study, 131 had started ART before TB diagnosis (44%). There were 45 deaths. There was no difference in mortality between ART-naïve patients and those with prior ART exposure. In the multivariate analysis, no ART...
Background Current international best practice recommendations urge breastfeeding for infants to ... more Background Current international best practice recommendations urge breastfeeding for infants to be exclusively breastfed until six months of age, with recognition that any breastfeeding for as long as possible affords benefits. Babies that are not exclusively breastfed are subject to infectious, atopic and metabolic diseases. In fact, several factors are associated with lack of exclusive breastfeeding such as nulliparity, delivery by caesarean section, the neonate not being put on the mother’s chest after delivery, multiple births, male gender, low birth weight and in case when neonate was resuscitated. Adequate interventions should be undertaken to overcome those barriers. This study reviewed the impact of mobile phone interventions in improve exclusive breastfeeding. Objectives To assess the effectiveness of mobile phone in improving exclusive breastfeeding. Search methods Randomized control trials were searched from January 2016 until February 2017. We searched through: CENTRAL,...
ObjectiveTo conduct a comprehensive systematic review and meta-analysis of all recommended SARS-C... more ObjectiveTo conduct a comprehensive systematic review and meta-analysis of all recommended SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) vaccines in people living with HIV (PLWH), as well as an overview of the safety, tolerability, and efficacy of the vaccines in PLWH.MethodsWe searched six databases, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Medline, Medrxiv, Global research on COVID-19 database, and Google Scholar for studies investigating the effects of SARS-CoV-2 vaccines on PLWH. Results of the association were summarised by SARS-CoV IgG seroconversion and level, vaccines efficacy and tolerability. A meta-analysis was performed for studies, using random-effects model and a pooled RR with 95% CI was reported.ResultsTwenty-three of the 1052 studies screened met the inclusion criteria. The review included 28, 246 participants among whom 79.55% (22,469/28, 246) were PLWH with median CD4 ≥ 200 cells/µL. The pooled estimate of SARS-CoV-2 IgG ser...
Background In the setting of maternal HIV-1, infant CMV infection is associated with impaired gro... more Background In the setting of maternal HIV-1, infant CMV infection is associated with impaired growth and development. HIV-1/CMV co-infected infants have a high risk of mortality, neurologic deficits, and HIV-1 disease progression. Infants may acquire CMV in utero, during delivery, or postnatal through breast milk or saliva. Maternal CMV antibodies protect against congenital disease and infection; but postnatal protection wanes rapidly. In sub-Saharan Africa, 80% of children acquire CMV during the first year of life, and acquisition may occur earlier if mothers have HIV-1. HAART started during the third trimester may decrease infant CMV infections, by mechanisms independent of breast milk CMV levels. Preventing or delaying CMV infection may represent a novel strategy to improve the health of both HIV-infected and HIV-exposed uninfected infants in sub–Saharan Africa, but requires a better understanding of CMV replication and transmission in the setting of maternal HIV-1. This review i...
Voluntary medical male circumcision (VMMC) reduces female-to-male HIV transmission by approximate... more Voluntary medical male circumcision (VMMC) reduces female-to-male HIV transmission by approximately 60% and is a recommended HIV prevention strategy in countries with high HIV prevalence and low levels of male circumcision. Mathematical models have illustrated that VMMC scale-up across Sub-Saharan Africa could prevent up to 6 million new HIV infections and 3 million deaths by 2025. Compared to the epidemic impact of scaling up ART to 90-90-90 levels, VMMC scale-up demonstrated additional reductions in HIV incidence and lower long-term annual program costs in models applied to several Sub-Saharan African countries. Therefore, low income countries are facing several challenges among which economic factors such as lost wages and opportunity costs of time are likely to be important barriers for VMMC uptake. Conditional cash transfers have shown its efficacy in many studies conducting low and middle countries where economic factors are impacting negatively on VMMC.
Human immunodeficiency virus-associated tuberculosis care in Botswana: evidence from a real-world setting, 2019
Background: Tuberculosis (TB) is among the world's top public health challenges and the leading k... more Background: Tuberculosis (TB) is among the world's top public health challenges and the leading killer of people with HIV, yet is a treatable disease. This study aimed to assess, in a real-world setting, the implementation of antiretroviral therapy (ART) and Cotrimoxazole preventive therapy (CPT) policy, specific interventions proven to benefit patients in HIV-associated TB care.
Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is hig... more Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is high, particularly in sub-Saharan Africa. This study aimed to compare mortality and predictors of mortality in those who were antiretroviral therapy (ART) naïve to those with prior ART exposure. This retrospective cohort study was conducted in Serowe/Palapye District, Botswana, a predominantly urban district with a large burden of HIV-associated TB with a high case fatality. Between January 1, 2013 and December 31, 2013, patients confirmed with HIV-associated TB were enrolled and followed up. Kaplan–Meier and Cox proportional hazard modeling was undertaken to identify predictors of mortality, with ART initiation included as time-updated variable. Among the 300 patients enrolled in the study, 131 had started ART before TB diagnosis (44%). There were 45 deaths. There was no difference in mortality between ART-naïve patients and those with prior ART exposure. In the multivariate analysis, no ART use during TB treatment (hazard ratio [HR] = 5.6, 95% confidence interval [CI] = 2.9–11; P < .001), opportunistic infections other than TB (HR = 8.5, 95% CI = 4–18.4; P = .013), age ≥60 years (HR = 4.8, 95% CI = 1.8–13; P = .002), hemoglobin <10 g/dL (HR = 2.4, 95% CI = 1.3–4.5) and hepatotoxicity (HR = 5, 95% CI = 1.6–17; P = .007) were associated with increased mortality. In the subgroup analysis, among ART-naïve patients, no ART use during TB treatment (HR = 8.1, 95% CI = 3.4–19.4; P < .001), opportunistic infections other than TB (HR = 16, 95% CI = 6.2–42; P < .001), and hepatotoxicity (HR = 8.3, 95% CI = 2.6–27; P < .001) were associated with mortality. Among patients with prior ART exposure, opportunistic infections other than TB (HR = 6, 95% CI = 2.6–27; P < .001) were associated with mortality. Mortality in patients with HIV-associated TB is still high. To reduce mortality, close clinical monitoring of patients together with initiation of ART during TB treatment is indicated. Abbreviations: 3TC = lamivudine, ART = antiretroviral therapy, AZT = zidovudine, EFV = efavirenz, FTC = emtricitabine, HIV = human immunodeficiency virus, LPV/r = ritonavir-boosted lopinavir, NVP = nevirapine, TB = tuberculosis, TDF = tenofovir.
Background
Current international best practice recommendations urge breastfeeding for infants to ... more Background Current international best practice recommendations urge breastfeeding for infants to be exclusively breastfed until six months of age, with recognition that any breastfeeding for as long as possible affords benefits. Babies that are not exclusively breastfed are subject to infectious, atopic and metabolic diseases. In fact, several factors are associated with lack of exclusive breastfeeding such as nulliparity, delivery by caesarean section, the neonate not being put on the mother’s chest after delivery, multiple births, male gender, low birth weight and in case when neonate was resuscitated. Adequate interventions should be undertaken to overcome those barriers. This study reviewed the impact of mobile phone interventions in improve exclusive breastfeeding.
Objectives To assess the effectiveness of mobile phone in improving exclusive breastfeeding.
Search methods Randomized control trials were searched from January 2016 until February 2017. We searched through: CENTRAL, MEDLINE via PUBMED, CINHAL, Scorpus, Web of science, handsearches of journals and the proceedings of major conferences
Selection criteria We selected randomized controlled trials (RCTs) assessing mobile phone intervention for improving breastfeeding. There was no language restriction.
Data collection and analysis Two authors (JLT and LMM) independently identified and assessed all studies that met inclusion criteria. Study design, characteristics of study populations, interventions and controls and study results were extracted by JLT and LMM. Also, the risk of bias of included studies was assessed independently by two JLT and LMM. We reported the overall results for each outcome after meta-analysis. We reported the odds ratio with 95% confidence intervals for the different outcomes.
Main results Based on the exclusive breastfeeding results, within one month, mobile phone interventions increased exclusive breastfeeding by 52% compared to the standard care (OR 1.52, 95%CI 1.25 to 1.84, 2130 participants, 7 RCTs). This result was statistically significant (P < 0.0001). The evidence was graded as high. As well as in two to three months postpartum, mobile phone intervention improved highly exclusive breastfeeding by 49% compared to the control group (OR 1.49, 95%CI 1.28 to 1.74, 3519 participants, 12 RCTs, p< 0.00001). Therefore, mobile phone intervention did not impact on exclusive breastfeeding within six months (OR 1.11, 95%CI 0.99 to 1.29, 3978 participants, 8 studies, p=0.17). In the other hand, formula feeding was more likely to be increased the standard care group compared to mobile phone intervention group in one month postpartum (OR 1.12 95%CI 0.85 to 1.47, 5 RCTs, 1358 participants, p-value=0.44). Even though, the result was not statistically significant. Therefore, within three months, formula feeding was significantly increased 27% compared to mobile phone group (OR 1.27 95%CI 1.05 to 1.54, 7 RCTS, 2359 participants, P=0.01). Lastly, formula feeding did not increase statistically after six months (OR 1.16 95%CI 0.99 to 1.35, 3066 participants, 5 RCTs, P = 0.06). Considering formula feeding, the overall evidence was moderate.
Authors' conclusions Our findings have shown the importance of mobile phone intervention in promoting exclusive breastfeeding. However, mobile phone intervention could not improve exclusive from four to six months. Further interventions should be studied to enforce exclusive breastfeeding within this specific period.
Abstract
Background
Estimated one million plus women worldwide are currently living with cervical... more Abstract Background Estimated one million plus women worldwide are currently living with cervical cancer. Many of them have not any access to health services for prevention, curative treatment or palliative care. Actually, cervical cancer is a public health issue in Sub-Saharan Africa as the result of the highest incidence of HIV-infected women. Pilot mHealth projects have shown that mobiles phones improve communication, information-delivery and information-retrieval processes over vast distances between healthcare service providers and patients. This study reviewed whether mHealth interventions could improve cancer screening uptake in risk women. Objectives To assess the effectiveness of different mHeath (SMS, calls, letters and emails reminders) interventions to improving cervical cancer screening in risk women. Search methods We searched for studies in MEDLINE, Scorpus, PsychINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, World Health Organization Global Health Library regional index, Mobile Active http:// www.mobileactive.org, Web of Science and Grey literature. In addition, hand-searching was performed for the original published version of this review. Selection criteria We included the following studies design: randomized control trials, quasi-experimental studies and non-randomized control trials assessing different mHealth interventions in improving cervical cancer screening outcomes. Data collection and analysis Two reviewers independently (JT and LM) identified and critically appraised all included studies. Study design, characteristics of study populations, interventions, controls and study results were extracted by two review authors. In addition, the risk of bias of included studies was assessed independently by two reviewers. We interpreted the results from meta-analysis. We reported the odds ratio with 95% CI. Main results We found 4731 studies in different electronic databases, 3004 studies were included after removing duplicated studies. Among them, 79 studies were fully assessed and then, 51 were excluded and 28 studies were assessed for eligibility criteria. 11 studies were excluded with reasons and 17 studies were included in meta-analysis. The overall results revealed that call reminders increased 44% of cervical cancer screening compared to the standard care, with pvalue of 0.01. 8 studies were included in this meta-analysis and the total number of participants was 29477. Call reminders improved 89% of cervical cancer screening adherence, with highly statistical results (Test for overall effect: Z = 5.23, P < 0.00001). 3 studies and 1340 participants were included. Lastly, letter reminders improved 20 % of cervical cancer screening compared to the standard care. 8 studies and 345835 participants were found in the overall results. Therefore, this result was not statistically significant (P=0.15). The overall evidence was judged as moderate and high when considering the effect of call reminders on cervical cancer screening and adherence to screen cervical cancer; therefore the impact of letter reminders on cervical cancer screening was very low. Authors' conclusions This systematic review supports the use of call reminders in improving cervical cancer screening and adherence to testing. The main outcomes were graded as high level of evidence. Then, call reminders could be suggested to be encompassed in different national policy in screening cervical cancer in risk populations. The lack of sufficient evidence on the subject limits the reliability of the current cervical cancer screening guidelines for high risk women is the leading cause of diagnosing cervical cancer in the last stage. Further studies in this field will provide the sole for preventing cervical cancer. However, this review could orientate public health policy makers.
Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is hig... more Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is high, particularly in sub-Saharan Africa. This study aimed to compare mortality and predictors of mortality in those who were antiretroviral therapy (ART) naïve to those with prior ART exposure.This retrospective cohort study was conducted in Serowe/Palapye District, Botswana, a predominantly urban district with a large burden of HIV-associated TB with a high case fatality. Between January 1, 2013 and December 31, 2013, patients confirmed with HIV-associated TB were enrolled and followed up. Kaplan-Meier and Cox proportional hazard modeling was undertaken to identify predictors of mortality, with ART initiation included as time-updated variable.Among the 300 patients enrolled in the study, 131 had started ART before TB diagnosis (44%). There were 45 deaths. There was no difference in mortality between ART-naïve patients and those with prior ART exposure. In the multivariate analysis, no ART...
Background Current international best practice recommendations urge breastfeeding for infants to ... more Background Current international best practice recommendations urge breastfeeding for infants to be exclusively breastfed until six months of age, with recognition that any breastfeeding for as long as possible affords benefits. Babies that are not exclusively breastfed are subject to infectious, atopic and metabolic diseases. In fact, several factors are associated with lack of exclusive breastfeeding such as nulliparity, delivery by caesarean section, the neonate not being put on the mother’s chest after delivery, multiple births, male gender, low birth weight and in case when neonate was resuscitated. Adequate interventions should be undertaken to overcome those barriers. This study reviewed the impact of mobile phone interventions in improve exclusive breastfeeding. Objectives To assess the effectiveness of mobile phone in improving exclusive breastfeeding. Search methods Randomized control trials were searched from January 2016 until February 2017. We searched through: CENTRAL,...
ObjectiveTo conduct a comprehensive systematic review and meta-analysis of all recommended SARS-C... more ObjectiveTo conduct a comprehensive systematic review and meta-analysis of all recommended SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) vaccines in people living with HIV (PLWH), as well as an overview of the safety, tolerability, and efficacy of the vaccines in PLWH.MethodsWe searched six databases, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Medline, Medrxiv, Global research on COVID-19 database, and Google Scholar for studies investigating the effects of SARS-CoV-2 vaccines on PLWH. Results of the association were summarised by SARS-CoV IgG seroconversion and level, vaccines efficacy and tolerability. A meta-analysis was performed for studies, using random-effects model and a pooled RR with 95% CI was reported.ResultsTwenty-three of the 1052 studies screened met the inclusion criteria. The review included 28, 246 participants among whom 79.55% (22,469/28, 246) were PLWH with median CD4 ≥ 200 cells/µL. The pooled estimate of SARS-CoV-2 IgG ser...
Background In the setting of maternal HIV-1, infant CMV infection is associated with impaired gro... more Background In the setting of maternal HIV-1, infant CMV infection is associated with impaired growth and development. HIV-1/CMV co-infected infants have a high risk of mortality, neurologic deficits, and HIV-1 disease progression. Infants may acquire CMV in utero, during delivery, or postnatal through breast milk or saliva. Maternal CMV antibodies protect against congenital disease and infection; but postnatal protection wanes rapidly. In sub-Saharan Africa, 80% of children acquire CMV during the first year of life, and acquisition may occur earlier if mothers have HIV-1. HAART started during the third trimester may decrease infant CMV infections, by mechanisms independent of breast milk CMV levels. Preventing or delaying CMV infection may represent a novel strategy to improve the health of both HIV-infected and HIV-exposed uninfected infants in sub–Saharan Africa, but requires a better understanding of CMV replication and transmission in the setting of maternal HIV-1. This review i...
Voluntary medical male circumcision (VMMC) reduces female-to-male HIV transmission by approximate... more Voluntary medical male circumcision (VMMC) reduces female-to-male HIV transmission by approximately 60% and is a recommended HIV prevention strategy in countries with high HIV prevalence and low levels of male circumcision. Mathematical models have illustrated that VMMC scale-up across Sub-Saharan Africa could prevent up to 6 million new HIV infections and 3 million deaths by 2025. Compared to the epidemic impact of scaling up ART to 90-90-90 levels, VMMC scale-up demonstrated additional reductions in HIV incidence and lower long-term annual program costs in models applied to several Sub-Saharan African countries. Therefore, low income countries are facing several challenges among which economic factors such as lost wages and opportunity costs of time are likely to be important barriers for VMMC uptake. Conditional cash transfers have shown its efficacy in many studies conducting low and middle countries where economic factors are impacting negatively on VMMC.
Human immunodeficiency virus-associated tuberculosis care in Botswana: evidence from a real-world setting, 2019
Background: Tuberculosis (TB) is among the world's top public health challenges and the leading k... more Background: Tuberculosis (TB) is among the world's top public health challenges and the leading killer of people with HIV, yet is a treatable disease. This study aimed to assess, in a real-world setting, the implementation of antiretroviral therapy (ART) and Cotrimoxazole preventive therapy (CPT) policy, specific interventions proven to benefit patients in HIV-associated TB care.
Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is hig... more Mortality in patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) is high, particularly in sub-Saharan Africa. This study aimed to compare mortality and predictors of mortality in those who were antiretroviral therapy (ART) naïve to those with prior ART exposure. This retrospective cohort study was conducted in Serowe/Palapye District, Botswana, a predominantly urban district with a large burden of HIV-associated TB with a high case fatality. Between January 1, 2013 and December 31, 2013, patients confirmed with HIV-associated TB were enrolled and followed up. Kaplan–Meier and Cox proportional hazard modeling was undertaken to identify predictors of mortality, with ART initiation included as time-updated variable. Among the 300 patients enrolled in the study, 131 had started ART before TB diagnosis (44%). There were 45 deaths. There was no difference in mortality between ART-naïve patients and those with prior ART exposure. In the multivariate analysis, no ART use during TB treatment (hazard ratio [HR] = 5.6, 95% confidence interval [CI] = 2.9–11; P < .001), opportunistic infections other than TB (HR = 8.5, 95% CI = 4–18.4; P = .013), age ≥60 years (HR = 4.8, 95% CI = 1.8–13; P = .002), hemoglobin <10 g/dL (HR = 2.4, 95% CI = 1.3–4.5) and hepatotoxicity (HR = 5, 95% CI = 1.6–17; P = .007) were associated with increased mortality. In the subgroup analysis, among ART-naïve patients, no ART use during TB treatment (HR = 8.1, 95% CI = 3.4–19.4; P < .001), opportunistic infections other than TB (HR = 16, 95% CI = 6.2–42; P < .001), and hepatotoxicity (HR = 8.3, 95% CI = 2.6–27; P < .001) were associated with mortality. Among patients with prior ART exposure, opportunistic infections other than TB (HR = 6, 95% CI = 2.6–27; P < .001) were associated with mortality. Mortality in patients with HIV-associated TB is still high. To reduce mortality, close clinical monitoring of patients together with initiation of ART during TB treatment is indicated. Abbreviations: 3TC = lamivudine, ART = antiretroviral therapy, AZT = zidovudine, EFV = efavirenz, FTC = emtricitabine, HIV = human immunodeficiency virus, LPV/r = ritonavir-boosted lopinavir, NVP = nevirapine, TB = tuberculosis, TDF = tenofovir.
Background
Current international best practice recommendations urge breastfeeding for infants to ... more Background Current international best practice recommendations urge breastfeeding for infants to be exclusively breastfed until six months of age, with recognition that any breastfeeding for as long as possible affords benefits. Babies that are not exclusively breastfed are subject to infectious, atopic and metabolic diseases. In fact, several factors are associated with lack of exclusive breastfeeding such as nulliparity, delivery by caesarean section, the neonate not being put on the mother’s chest after delivery, multiple births, male gender, low birth weight and in case when neonate was resuscitated. Adequate interventions should be undertaken to overcome those barriers. This study reviewed the impact of mobile phone interventions in improve exclusive breastfeeding.
Objectives To assess the effectiveness of mobile phone in improving exclusive breastfeeding.
Search methods Randomized control trials were searched from January 2016 until February 2017. We searched through: CENTRAL, MEDLINE via PUBMED, CINHAL, Scorpus, Web of science, handsearches of journals and the proceedings of major conferences
Selection criteria We selected randomized controlled trials (RCTs) assessing mobile phone intervention for improving breastfeeding. There was no language restriction.
Data collection and analysis Two authors (JLT and LMM) independently identified and assessed all studies that met inclusion criteria. Study design, characteristics of study populations, interventions and controls and study results were extracted by JLT and LMM. Also, the risk of bias of included studies was assessed independently by two JLT and LMM. We reported the overall results for each outcome after meta-analysis. We reported the odds ratio with 95% confidence intervals for the different outcomes.
Main results Based on the exclusive breastfeeding results, within one month, mobile phone interventions increased exclusive breastfeeding by 52% compared to the standard care (OR 1.52, 95%CI 1.25 to 1.84, 2130 participants, 7 RCTs). This result was statistically significant (P < 0.0001). The evidence was graded as high. As well as in two to three months postpartum, mobile phone intervention improved highly exclusive breastfeeding by 49% compared to the control group (OR 1.49, 95%CI 1.28 to 1.74, 3519 participants, 12 RCTs, p< 0.00001). Therefore, mobile phone intervention did not impact on exclusive breastfeeding within six months (OR 1.11, 95%CI 0.99 to 1.29, 3978 participants, 8 studies, p=0.17). In the other hand, formula feeding was more likely to be increased the standard care group compared to mobile phone intervention group in one month postpartum (OR 1.12 95%CI 0.85 to 1.47, 5 RCTs, 1358 participants, p-value=0.44). Even though, the result was not statistically significant. Therefore, within three months, formula feeding was significantly increased 27% compared to mobile phone group (OR 1.27 95%CI 1.05 to 1.54, 7 RCTS, 2359 participants, P=0.01). Lastly, formula feeding did not increase statistically after six months (OR 1.16 95%CI 0.99 to 1.35, 3066 participants, 5 RCTs, P = 0.06). Considering formula feeding, the overall evidence was moderate.
Authors' conclusions Our findings have shown the importance of mobile phone intervention in promoting exclusive breastfeeding. However, mobile phone intervention could not improve exclusive from four to six months. Further interventions should be studied to enforce exclusive breastfeeding within this specific period.
Abstract
Background
Estimated one million plus women worldwide are currently living with cervical... more Abstract Background Estimated one million plus women worldwide are currently living with cervical cancer. Many of them have not any access to health services for prevention, curative treatment or palliative care. Actually, cervical cancer is a public health issue in Sub-Saharan Africa as the result of the highest incidence of HIV-infected women. Pilot mHealth projects have shown that mobiles phones improve communication, information-delivery and information-retrieval processes over vast distances between healthcare service providers and patients. This study reviewed whether mHealth interventions could improve cancer screening uptake in risk women. Objectives To assess the effectiveness of different mHeath (SMS, calls, letters and emails reminders) interventions to improving cervical cancer screening in risk women. Search methods We searched for studies in MEDLINE, Scorpus, PsychINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, World Health Organization Global Health Library regional index, Mobile Active http:// www.mobileactive.org, Web of Science and Grey literature. In addition, hand-searching was performed for the original published version of this review. Selection criteria We included the following studies design: randomized control trials, quasi-experimental studies and non-randomized control trials assessing different mHealth interventions in improving cervical cancer screening outcomes. Data collection and analysis Two reviewers independently (JT and LM) identified and critically appraised all included studies. Study design, characteristics of study populations, interventions, controls and study results were extracted by two review authors. In addition, the risk of bias of included studies was assessed independently by two reviewers. We interpreted the results from meta-analysis. We reported the odds ratio with 95% CI. Main results We found 4731 studies in different electronic databases, 3004 studies were included after removing duplicated studies. Among them, 79 studies were fully assessed and then, 51 were excluded and 28 studies were assessed for eligibility criteria. 11 studies were excluded with reasons and 17 studies were included in meta-analysis. The overall results revealed that call reminders increased 44% of cervical cancer screening compared to the standard care, with pvalue of 0.01. 8 studies were included in this meta-analysis and the total number of participants was 29477. Call reminders improved 89% of cervical cancer screening adherence, with highly statistical results (Test for overall effect: Z = 5.23, P < 0.00001). 3 studies and 1340 participants were included. Lastly, letter reminders improved 20 % of cervical cancer screening compared to the standard care. 8 studies and 345835 participants were found in the overall results. Therefore, this result was not statistically significant (P=0.15). The overall evidence was judged as moderate and high when considering the effect of call reminders on cervical cancer screening and adherence to screen cervical cancer; therefore the impact of letter reminders on cervical cancer screening was very low. Authors' conclusions This systematic review supports the use of call reminders in improving cervical cancer screening and adherence to testing. The main outcomes were graded as high level of evidence. Then, call reminders could be suggested to be encompassed in different national policy in screening cervical cancer in risk populations. The lack of sufficient evidence on the subject limits the reliability of the current cervical cancer screening guidelines for high risk women is the leading cause of diagnosing cervical cancer in the last stage. Further studies in this field will provide the sole for preventing cervical cancer. However, this review could orientate public health policy makers.
Uploads
Papers by Ley Muyaya
Current international best practice recommendations urge breastfeeding for infants to be exclusively breastfed until six months of age, with recognition that any breastfeeding for as long as possible affords
benefits. Babies that are not exclusively breastfed are subject to infectious, atopic and metabolic diseases. In fact, several factors are associated with lack of exclusive breastfeeding such as nulliparity, delivery by caesarean section, the neonate not being put on the mother’s chest after delivery, multiple births, male gender, low birth weight and in case when neonate was resuscitated. Adequate interventions should
be undertaken to overcome those barriers. This study reviewed the impact of mobile phone interventions in improve exclusive
breastfeeding.
Objectives
To assess the effectiveness of mobile phone in improving exclusive breastfeeding.
Search methods
Randomized control trials were searched from January 2016 until February 2017. We searched through: CENTRAL, MEDLINE via PUBMED, CINHAL, Scorpus, Web of science, handsearches of journals and the
proceedings of major conferences
Selection criteria
We selected randomized controlled trials (RCTs) assessing mobile phone intervention for improving breastfeeding. There was no language restriction.
Data collection and analysis
Two authors (JLT and LMM) independently identified and assessed all studies that met inclusion criteria. Study design, characteristics of study populations, interventions and controls and study results were extracted by JLT and LMM. Also, the risk of bias of included studies was assessed
independently by two JLT and LMM. We reported the overall results for each outcome after meta-analysis. We reported the odds ratio with 95% confidence intervals for the different outcomes.
Main results
Based on the exclusive breastfeeding results, within one month, mobile phone interventions increased exclusive breastfeeding by 52% compared to the standard care (OR 1.52, 95%CI 1.25 to 1.84, 2130 participants, 7 RCTs). This result was statistically significant (P < 0.0001). The evidence was graded as high. As well as in two to three months postpartum, mobile phone intervention improved highly exclusive breastfeeding by 49% compared to the control group (OR 1.49, 95%CI 1.28 to
1.74, 3519 participants, 12 RCTs, p< 0.00001). Therefore, mobile phone
intervention did not impact on exclusive breastfeeding within six months (OR 1.11, 95%CI 0.99 to 1.29, 3978 participants, 8 studies, p=0.17).
In the other hand, formula feeding was more likely to be increased the standard care group compared to mobile phone intervention group in one month postpartum (OR 1.12 95%CI 0.85 to 1.47, 5 RCTs, 1358 participants, p-value=0.44). Even though, the result was not statistically
significant. Therefore, within three months, formula feeding was significantly increased 27% compared to mobile phone group (OR 1.27 95%CI 1.05 to 1.54, 7 RCTS, 2359 participants, P=0.01). Lastly, formula
feeding did not increase statistically after six months (OR 1.16 95%CI 0.99 to 1.35, 3066 participants, 5 RCTs, P = 0.06). Considering formula feeding, the overall evidence was moderate.
Authors' conclusions
Our findings have shown the importance of mobile phone intervention in promoting exclusive breastfeeding. However, mobile phone intervention could not improve exclusive from four to six months. Further interventions should be studied to enforce exclusive breastfeeding within this specific period.
Background
Estimated one million plus women worldwide are currently living with cervical cancer. Many of
them have not any access to health services for prevention, curative treatment or palliative care.
Actually, cervical cancer is a public health issue in Sub-Saharan Africa as the result of the
highest incidence of HIV-infected women. Pilot mHealth projects have shown that mobiles
phones improve communication, information-delivery and information-retrieval processes over
vast distances between healthcare service providers and patients. This study reviewed whether
mHealth interventions could improve cancer screening uptake in risk women.
Objectives
To assess the effectiveness of different mHeath (SMS, calls, letters and emails reminders)
interventions to improving cervical cancer screening in risk women.
Search methods
We searched for studies in MEDLINE, Scorpus, PsychINFO, Cochrane Central Register of
Controlled Trials (CENTRAL), CINAHL, World Health Organization Global Health Library
regional index, Mobile Active http:// www.mobileactive.org, Web of Science and Grey literature.
In addition, hand-searching was performed for the original published version of this review.
Selection criteria
We included the following studies design: randomized control trials, quasi-experimental studies
and non-randomized control trials assessing different mHealth interventions in improving
cervical cancer screening outcomes.
Data collection and analysis
Two reviewers independently (JT and LM) identified and critically appraised all included
studies. Study design, characteristics of study populations, interventions, controls and study
results were extracted by two review authors. In addition, the risk of bias of included studies was
assessed independently by two reviewers. We interpreted the results from meta-analysis. We
reported the odds ratio with 95% CI.
Main results
We found 4731 studies in different electronic databases, 3004 studies were included after
removing duplicated studies. Among them, 79 studies were fully assessed and then, 51 were
excluded and 28 studies were assessed for eligibility criteria. 11 studies were excluded with
reasons and 17 studies were included in meta-analysis. The overall results revealed that call
reminders increased 44% of cervical cancer screening compared to the standard care, with pvalue
of 0.01. 8 studies were included in this meta-analysis and the total number of participants
was 29477. Call reminders improved 89% of cervical cancer screening adherence, with highly
statistical results (Test for overall effect: Z = 5.23, P < 0.00001). 3 studies and 1340 participants
were included. Lastly, letter reminders improved 20 % of cervical cancer screening compared to
the standard care. 8 studies and 345835 participants were found in the overall results. Therefore,
this result was not statistically significant (P=0.15).
The overall evidence was judged as moderate and high when considering the effect of call
reminders on cervical cancer screening and adherence to screen cervical cancer; therefore the
impact of letter reminders on cervical cancer screening was very low.
Authors' conclusions
This systematic review supports the use of call reminders in improving cervical cancer screening
and adherence to testing. The main outcomes were graded as high level of evidence. Then, call
reminders could be suggested to be encompassed in different national policy in screening
cervical cancer in risk populations. The lack of sufficient evidence on the subject limits the
reliability of the current cervical cancer screening guidelines for high risk women is the leading
cause of diagnosing cervical cancer in the last stage. Further studies in this field will provide the
sole for preventing cervical cancer. However, this review could orientate public health policy
makers.
Current international best practice recommendations urge breastfeeding for infants to be exclusively breastfed until six months of age, with recognition that any breastfeeding for as long as possible affords
benefits. Babies that are not exclusively breastfed are subject to infectious, atopic and metabolic diseases. In fact, several factors are associated with lack of exclusive breastfeeding such as nulliparity, delivery by caesarean section, the neonate not being put on the mother’s chest after delivery, multiple births, male gender, low birth weight and in case when neonate was resuscitated. Adequate interventions should
be undertaken to overcome those barriers. This study reviewed the impact of mobile phone interventions in improve exclusive
breastfeeding.
Objectives
To assess the effectiveness of mobile phone in improving exclusive breastfeeding.
Search methods
Randomized control trials were searched from January 2016 until February 2017. We searched through: CENTRAL, MEDLINE via PUBMED, CINHAL, Scorpus, Web of science, handsearches of journals and the
proceedings of major conferences
Selection criteria
We selected randomized controlled trials (RCTs) assessing mobile phone intervention for improving breastfeeding. There was no language restriction.
Data collection and analysis
Two authors (JLT and LMM) independently identified and assessed all studies that met inclusion criteria. Study design, characteristics of study populations, interventions and controls and study results were extracted by JLT and LMM. Also, the risk of bias of included studies was assessed
independently by two JLT and LMM. We reported the overall results for each outcome after meta-analysis. We reported the odds ratio with 95% confidence intervals for the different outcomes.
Main results
Based on the exclusive breastfeeding results, within one month, mobile phone interventions increased exclusive breastfeeding by 52% compared to the standard care (OR 1.52, 95%CI 1.25 to 1.84, 2130 participants, 7 RCTs). This result was statistically significant (P < 0.0001). The evidence was graded as high. As well as in two to three months postpartum, mobile phone intervention improved highly exclusive breastfeeding by 49% compared to the control group (OR 1.49, 95%CI 1.28 to
1.74, 3519 participants, 12 RCTs, p< 0.00001). Therefore, mobile phone
intervention did not impact on exclusive breastfeeding within six months (OR 1.11, 95%CI 0.99 to 1.29, 3978 participants, 8 studies, p=0.17).
In the other hand, formula feeding was more likely to be increased the standard care group compared to mobile phone intervention group in one month postpartum (OR 1.12 95%CI 0.85 to 1.47, 5 RCTs, 1358 participants, p-value=0.44). Even though, the result was not statistically
significant. Therefore, within three months, formula feeding was significantly increased 27% compared to mobile phone group (OR 1.27 95%CI 1.05 to 1.54, 7 RCTS, 2359 participants, P=0.01). Lastly, formula
feeding did not increase statistically after six months (OR 1.16 95%CI 0.99 to 1.35, 3066 participants, 5 RCTs, P = 0.06). Considering formula feeding, the overall evidence was moderate.
Authors' conclusions
Our findings have shown the importance of mobile phone intervention in promoting exclusive breastfeeding. However, mobile phone intervention could not improve exclusive from four to six months. Further interventions should be studied to enforce exclusive breastfeeding within this specific period.
Background
Estimated one million plus women worldwide are currently living with cervical cancer. Many of
them have not any access to health services for prevention, curative treatment or palliative care.
Actually, cervical cancer is a public health issue in Sub-Saharan Africa as the result of the
highest incidence of HIV-infected women. Pilot mHealth projects have shown that mobiles
phones improve communication, information-delivery and information-retrieval processes over
vast distances between healthcare service providers and patients. This study reviewed whether
mHealth interventions could improve cancer screening uptake in risk women.
Objectives
To assess the effectiveness of different mHeath (SMS, calls, letters and emails reminders)
interventions to improving cervical cancer screening in risk women.
Search methods
We searched for studies in MEDLINE, Scorpus, PsychINFO, Cochrane Central Register of
Controlled Trials (CENTRAL), CINAHL, World Health Organization Global Health Library
regional index, Mobile Active http:// www.mobileactive.org, Web of Science and Grey literature.
In addition, hand-searching was performed for the original published version of this review.
Selection criteria
We included the following studies design: randomized control trials, quasi-experimental studies
and non-randomized control trials assessing different mHealth interventions in improving
cervical cancer screening outcomes.
Data collection and analysis
Two reviewers independently (JT and LM) identified and critically appraised all included
studies. Study design, characteristics of study populations, interventions, controls and study
results were extracted by two review authors. In addition, the risk of bias of included studies was
assessed independently by two reviewers. We interpreted the results from meta-analysis. We
reported the odds ratio with 95% CI.
Main results
We found 4731 studies in different electronic databases, 3004 studies were included after
removing duplicated studies. Among them, 79 studies were fully assessed and then, 51 were
excluded and 28 studies were assessed for eligibility criteria. 11 studies were excluded with
reasons and 17 studies were included in meta-analysis. The overall results revealed that call
reminders increased 44% of cervical cancer screening compared to the standard care, with pvalue
of 0.01. 8 studies were included in this meta-analysis and the total number of participants
was 29477. Call reminders improved 89% of cervical cancer screening adherence, with highly
statistical results (Test for overall effect: Z = 5.23, P < 0.00001). 3 studies and 1340 participants
were included. Lastly, letter reminders improved 20 % of cervical cancer screening compared to
the standard care. 8 studies and 345835 participants were found in the overall results. Therefore,
this result was not statistically significant (P=0.15).
The overall evidence was judged as moderate and high when considering the effect of call
reminders on cervical cancer screening and adherence to screen cervical cancer; therefore the
impact of letter reminders on cervical cancer screening was very low.
Authors' conclusions
This systematic review supports the use of call reminders in improving cervical cancer screening
and adherence to testing. The main outcomes were graded as high level of evidence. Then, call
reminders could be suggested to be encompassed in different national policy in screening
cervical cancer in risk populations. The lack of sufficient evidence on the subject limits the
reliability of the current cervical cancer screening guidelines for high risk women is the leading
cause of diagnosing cervical cancer in the last stage. Further studies in this field will provide the
sole for preventing cervical cancer. However, this review could orientate public health policy
makers.