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Okusanya B, Kimaru LJ, Mantina N, Gerald LB, Pettygrove S, Taren D, Ehiri J. Interventions to increase early infant diagnosis of HIV infection: A systematic review and meta-analysis. PLoS One 2022; 17:e0258863. [PMID: 35213579 PMCID: PMC8880648 DOI: 10.1371/journal.pone.0258863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/06/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives
Early infant diagnosis (EID) of HIV infection increases antiretroviral therapy initiation, which reduces pediatric HIV-related morbidity and mortality. This review aims to critically appraise the effects of interventions to increase uptake of early infant diagnosis.
Design
This is a systematic review and meta-analysis of interventions to increase the EID of HIV infection. We searched PubMed, EMBASE, CINAHL, and PsycINFO to identify eligible studies from inception of these databases to June 18, 2020. EID Uptake at 4–8 weeks of age was primary outcome assessed by the review. We conducted meta-analysis, using data from reports of included studies. The measure of the effect of dichotomous data was odds ratios (OR), with a 95% confidence interval. The grading of recommendations assessment, development, and evaluation (GRADE) approach was used to assess quality of evidence.
Settings
The review was not limited by time of publication or setting in which the studies conducted.
Participants
HIV-exposed infants were participants.
Results
Database search and review of reference lists yielded 923 unique titles, out of which 16 studies involving 13,822 HIV exposed infants (HEI) were eligible for inclusion in the review. Included studies were published between 2014 and 2019 from Kenya, Nigeria, Uganda, South Africa, Zambia, and India. Of the 16 included studies, nine (experimental) and seven (observational) studies included had low to moderate risk of bias. The studies evaluated eHealth services (n = 6), service improvement (n = 4), service integration (n = 2), behavioral interventions (n = 3), and male partner involvement (n = 1). Overall, there was no evidence that any of the evaluated interventions, including eHealth, health systems improvements, integration of EID, conditional cash transfer, mother-to-mother support, or partner (male) involvement, was effective in increasing uptake of EID at 4–8 weeks of age. There was also no evidence that any intervention was effective in increasing HIV-infected infants’ identification at 4–8 weeks of age.
Conclusions
There is limited evidence to support the hypothesis that interventions implemented to increase uptake of EID were effective at 4–8 weeks of life. Further research is required to identify effective interventions that increase early infant diagnosis of HIV at 4–8 weeks of age.
Prospero number
(CRD42020191738).
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Affiliation(s)
- Babasola Okusanya
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
- * E-mail:
| | - Linda J. Kimaru
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Namoonga Mantina
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Lynn B. Gerald
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Sydney Pettygrove
- Department of Epidemiology, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Douglas Taren
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
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Habila MA, Kimaru LJ, Mantina N, Valencia DY, McClelland DJ, Musa J, Madhivanan P, Sagay A, Jacobs ET. Community-Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review. Front Glob Womens Health 2021; 2:697607. [PMID: 34816234 PMCID: PMC8594022 DOI: 10.3389/fgwh.2021.697607] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/25/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Cervical cancer remains one of the top causes of cancer mortality among African women. Cervical cancer screening and early detection and treatment of precancer is one of the evidence-based interventions to reduce incidence and mortality. The application of community-based participatory research (CBPR) has been used in the United States to improve participation in screening and reduce cervical cancer disparities. However, it is unclear whether these engaged approaches have been used in sub-Saharan African to address disparities related to cervical cancer mortality. Objectives: Highlight community engagement in cervical cancer prevention and control in Sub-Saharan Africa (SSA), describe the community engagement efforts that are currently being used, and to describe the best practices for community engagement toward the end-goal of cervical cancer prevention and control. Methods: We searched PubMed, Embase, CINHAL, African Journals Online (AJOL), and African Index Medicus-WHO from inception until June 8, 2020. After screening 620 titles and abstracts, and reviewing 56 full-text articles according to inclusion and exclusion criteria, 9 articles met the selection criteria and were included. Relevant data variables were extracted from the included articles and a narrative synthesis was performed. Results: Between 2005 and 2019, 9 articles describing research in Ghana, Kenya, Zambia, Senegal, South Africa, and Nigeria were included. These articles described work that largely took place in rural settings predominantly among women age 15-65 years. Leveraging community networks such as community health workers, religious organizations, traditional leaders, and educational institutions increased awareness of cervical cancer. Working within existing social structures and training community members through the research effort were promising methods for addressing the disparities in cervical cancer incidence and mortality among communities. Discussion: The findings of this scoping review have contributed to the understanding of which novel approaches to community-based practices can be used to address cervical cancer disparities among SSA communities that carry a disproportionate disease burden. Community engagement in the research process, while effortful, has shown to be beneficial to researchers and to the communities that they serve, and provides valuable next steps in the effort to address cervical cancer disparities in SSA.
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Affiliation(s)
- Magdiel A. Habila
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, United States
- Department of Health and Pharmaceutical Outcomes, University of Arizona, Tucson, AZ, United States
| | - Linda Jepkoech Kimaru
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | - Namoonga Mantina
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | - Dora Yesenia Valencia
- Clinical Translational Sciences, College of Medicine, University of Arizona Health Sciences, Tucson, AZ, United States
| | - D. Jean McClelland
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
- Health Sciences Library, University of Arizona, Tucson, AZ, United States
| | - Jonah Musa
- Department of Obstetrics and Gynecology, Jos University Teaching Hospital, Jos, Nigeria
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Northwestern University, Chicago, IL, United States
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | - Atiene Sagay
- Department of Obstetrics and Gynecology, Jos University Teaching Hospital, Jos, Nigeria
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, United States
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Abstract
As student populations become more diverse, it is essential for educators, administrators, and institutions to implement practices that ensure the success of all students. This is particularly true in the sciences, as students from traditionally underrepresented populations in STEM compose an increasingly greater proportion of the national student demographic. The Teaching Section of the American Physiological Society sponsored a symposium, "Inclusive Practices for Diverse Student Populations," at 2017 Experimental Biology in Chicago, IL, introducing practices that promote inclusion in diverse student populations in STEM. The symposium began with an introduction to quantitative and qualitative assessment strategies of equity and inclusion. The second half of the symposium discussed structural bias and effective inclusive practices.
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Affiliation(s)
- Kathryn M S Johnson
- Department of Biology, Beloit College , Beloit, Wisconsin
- Trail Build LLC, East Troy , Wisconsin
| | - Amy Briggs
- Department of Biology, Beloit College , Beloit, Wisconsin
| | - Christine Hawn
- Department of Geography and Environmental Systems, University of Maryland-Baltimore County , Baltimore, Maryland
| | | | - Brett C Woods
- Department of Biology, High Point University , High Point, North Carolina
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