Browsing by Author "Nyasulu, Peter S."

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    Assessing the uncertainty around age-mixing patterns in HIV transmission inferred from phylogenetic trees
    (Public Library of Science, 2021) Niyukuri, David; Nyasulu, Peter S.; Delva, Wim
    Understanding age-mixing patterns in Human Immunodeficiency Virus (HIV) transmission networks can enhance the design and implementation of HIV prevention strategies in sub-Saharan Africa. Due to ethical consideration, it is less likely possible to conduct a benchmark study to assess which sampling strategy, and sub-optimal sampling coverage which can yield best estimates for these patterns. We conducted a simulation study, using phylogenetic trees to infer estimates of age-mixing patterns in HIV transmission, through the computation of proportions of pairings between men and women, who were phylogenetically linked across different age groups (15–24 years, 25–39 years, and 40–49 years); and the means, and standard deviations of their age difference. We investigated also the uncertainty around these estimates as a function of the sampling coverage in four sampling strategies: when missing sequence data were missing completely at random (MCAR), and missing at random (MAR) with at most 30%—50%—70% of women in different age groups being in the sample. The results suggested that age-mixing patterns in HIV transmission can be unveiled from proportions of phylogenetic pairings between men and women across age groups; and the mean, and standard deviation of their age difference. A 55% sampling coverage was sufficient to provide the best values of estimates of age-mixing patterns in HIV transmission with MCAR scenario. But we should be cautious in interpreting proportions of men phylogenetically linked to women because they may be overestimated or underestimated, even at higher sampling coverage. The findings showed that, MCAR was the best sampling strategy. This means, it is advisable not to use sequence data collected in settings where we can find a systematic imbalance of age and gender to investigate age-mixing in HIV transmission. If not possible, ensure to take into consideration the imbalance in interpreting the results.
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    Dzherelo (Immunoxel) as adjunctive therapy to standard antituberculosis treatment in patients with pulmonary tuberculosis : a systematic review and meta-analysis of clinical trials
    (BMC (part of Springer Nature), 2021-05-26) Kitenge, Marcel; Phiri, Bessie; Pheeha, Sara M.; Ogunrombi, Modupe; Nyasulu, Peter S.
    Background: Dzherelo (Immunoxel) is one of the few approved immunomodulators that has been shown to produce positive treatment outcomes in patients with tuberculosis (TB). The aim of this review was to assess the effectiveness of Immunoxel used as adjunct therapy with conventional anti-TB therapy for the treatment of pulmonary TB. Methods: Comprehensive search was conducted in different major databases: PubMed (MEDLINE), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Scopus (Elsevier). We also searched Google Scholar along with trial registries and hand-searched the reference list of identified original research as well as review articles. Conference proceedings of relevant TB and lung disease annual conferences were also screened. Two independent authors extracted outcome data using a standardised extraction form. Relative risk (RR), mean difference (MD) and standardised mean difference (SMD) with a 95% confidence interval (CI) were used as measures of effect. We assessed certainty of evidence using GRADE. Results: Six clinical trials, which met the criteria for the review, were identified, and these provided data for the review. Overall results from the six trials that compared antituberculosis treatment (ATT) alone versus ATT and Immunoxel, and ATT and placebo versus ATT and Immunoxel showed an increased number of patients becoming sputum-negative in the Immunoxel group (RR 3.19; 95% CI 2.44 to 4.17; 488 participants). There was also reduction in body temperature among patients receiving Immunoxel compared to ATT alone (MD −0.20, 95% CI −0.22 to −0.18, 345 participants). However, there were no differences in body weight changes across all the studies (MD 5.65; 95% CI −0.80 to 12.11; 382 participants). Conclusion: Current evidence indicates that the use of Immunoxel as an adjunctive treatment in patients with pulmonary tuberculosis has the potential to enhance the efficacy of antituberculosis treatment. However, welldesigned, conducted and adequately powered clinical trials are needed to establish the effectiveness of this adjunctive treatment.
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    Effect of community-based interventions targeting female sex workers along the HIV care cascade in sub-Saharan Africa : a systematic review and meta-analysis
    (BMC (part of Springer Nature), 2021-05-06) Atuhaire, Lydia; Adetokunboh, Olatunji; Shumba, Constance; Nyasulu, Peter S.
    Background: Female sex workers are extremely vulnerable and highly susceptible to being infected with human immunodeficiency virus. As a result, community-based targeted interventions have been recommended as one of the models of care to improve access to HIV services and continued engagement in care. We conducted a systematic review to (1) assess the effect of FSW-targeted community interventions on the improvement of HIV services access along the treatment cascade and (2) describe community-based interventions that positively affect continuation in HIV care across the HIV treatment cascade for FSWs in sub-Saharan Africa. Methods: We defined the 5 steps that make up the HIV care cascade and categorized them as outcomes, namely, HIV testing and diagnosis, linkage to care, receipt of ART, and achievement of viral suppression. We conducted a systematic search of randomized controlled trials, cohort, and cross-sectional studies done in sub-Saharan African countries and published from 2004 to 2020. The period was selected based on the time span within which ART was scaled up through widespread roll-out of comprehensive HIV programs in sub-Saharan Africa. We reviewed studies with data on the implementation of community interventions for any of the HIV care cascade stage. The data were analyzed using random effects meta-analysis where possible, and for the rest of the studies, data were synthesized using summary statistics. Results: The significant impact of the community interventions was observed on HIV testing, HIV diagnosis, and ART use. However, for HIV testing and ART use, the improvement was not sustained for the entire period of implementation. There were minimal interventions that had impact on HIV diagnosis, with only one community service delivery model showing significance. Generally, the interventions that had reasonable impact are those that implemented targeted and comprehensive package of HIV services provided at one location, and with unique strategies specific to each cascade stage. Conclusions: The evidence brought forward from this review shows that the effect of community-based interventions varies across the different stages of HIV care cascade. A broad package of interventions including a combination of behavioral, biomedical, and structural, designed with specific strategies, unique to each cascade stage appears to be more effective, although information on long-term treatment outcomes and the extent to which FSWs remain engaged in care is sparse. There is need to conduct a further research to deepen the assessment of the effectiveness of community-based interventions on HIV care cascade for FSWs. This will enhance identification of evidence-based optimal interventions that will guide effective allocation of scarce resources for strategies that would have a significant impact on HIV service delivery.
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    Effect of female sex work-targeted community-based interventions along the HIV treatment cascade in sub-Saharan Africa : a systematic review protocol
    (BMJ Publishing Group, 2020) Atuhaire, Lydia; Adetokunboh, Olatunji; Shumba, Constance; Nyasulu, Peter S.
    Introduction: Female sex workers (FSWs) are a known high-risk group that are at increased risk of HIV transmission due to exposure to multiple sexual partners and inability to negotiate safe sex attributed to challenging economic circumstances. Previous systematic reviews have examined the effectiveness of HIV interventions prioritising FSWs and have shown that targeted interventions improve access to HIV prevention and treatment services. Interventions that increase FSWs’ uptake of services are well documented; however, evidence on specific interventions aimed at improving FSWs’ continuity in HIV care along the treatment cascade is lacking. This systematic review aims to document the performance of community-based interventions along the HIV treatment cascade. Methods and analysis: We will use a sensitive search strategy for electronic bibliographic databases, bibliographies of included articles and grey literature sources. In addition, the Joint United Nations Programme on HIV/AIDS and the WHO websites, peer-reviewed conference papers and grey literature sources will be searched for additional reports of sex work programmes. We will include randomised controlled trials, cross-sectional surveys and cohort interventions where community-based HIV services were provided to FSWs and measure the performance of the HIV intervention on one or more cascade stages. We will conduct a systematic review of studies published from 2004 to present within the sub-Saharan Africa region. We will report quantitative study outcomes of HIV testing and diagnosis, linkage to care, initiation on antiretroviral therapy and viral suppression. We will analyse the data using the random-effects meta-analysis method, and funnel plots will be used to assess the publication bias. Ethics and dissemination: This systematic review will not require ethical approval; we will publish data from manuscripts. The results of this study will be disseminated in peer-reviewed journals and conference presentations.
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    Effects of antiretroviral therapy in HIV-positive adults on new HIV infections among young women : a systematic review protocol
    (BMC, 2019-03-05) Chibawara, Trust; Mbuagbaw, Lawrence; Kitenge, Marcel; Nyasulu, Peter S.
    Background: The HIV/AIDS pandemic has struck regions, countries, and populations in different ways. With the introduction of antiretroviral drugs, people living with HIV (PLHIV) have a much better prognosis, even though there are still many new infections in young women. The role of widespread antiretroviral therapy (ART) on the incidence of HIV in young women is unknown. Methods: We will conduct a comprehensive search of MEDLINE (PubMed), Excerpta Medica database (EMBASE), Scopus, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), World Health Organization’s (WHO’s) library database, Latin American and Caribbean Health Sciences Literature (LILACS), conference abstracts, and gray literature sources to identify any relevant literature. We will include randomized and non-randomized clinical trials and cohort studies in which ART was offered to adults aged 18 and above reporting outcomes in females aged 15 to 24 years. The outcomes of interest are HIV incidence, ART initiation, adherence, retention, and viral load suppression. We will screen titles, abstracts, and the full texts of relevant articles in duplicate. Disagreements will be resolved by consensus. We will extract data on the risk of HIV infection in younger females after the use of ART in the adult population. Discussion: To our knowledge, this is the first systematic review to look at the impact of ART use among adults on HIV incidence in young women. The results of this review will be used in a modeling study to simulate the effects of using ART as an effective tool to prevent sexual transmission of HIV to young women. Our findings will inform the treatment-as-prevention (TasP) strategy to reduce new HIV infections among young women.
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    Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings : a systematic review and meta analysis
    (BMC (part of Springer Nature), 2020) Lailulo, Yishak; Kitenge, Marcel; Jaffer, Shahista; Aluko, Omololu; Nyasulu, Peter S.
    Background: Despite the increase in the number of people accessing antiretroviral therapy (ART), there is limited data regarding treatment failure and its related factors among HIV-positive individuals enrolled in HIV care in resource-poor settings. This review aimed to identify factors associated with antiretroviral treatment failure among individuals living with HIV on ART in resource-poor settings. Methods: We conducted a comprehensive search on MEDLINE (PubMed), Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), World Health Organization’s (WHO’s) library database, and Latin American and Caribbean Health Sciences Literature (LILACS). We included observational studies (cohort, casecontrol, and cross-sectional studies) where adolescents and adults living with HIV were on antiretroviral treatment regardless of the ART regimen. The primary outcomes of interest were immunological, virological, and clinical failure. Some of the secondary outcomes were mm3 opportunistic infections, WHO clinical stage, and sociodemographic factors. We screened titles, abstracts, and the full texts of relevant articles in duplicate. Disagreements Results: Antiretroviral failure was nearly 6 times higher among patients who had poor adherence to treatment as compared to patients with a good treatment adherence (OR = 5.90, 95% CI 3.50, 9.94, moderate strength of evidence). The likelihood of the treatment failure was almost 5 times higher among patients with CD4 < 200 cells/ mm3 compared to those with CD4 ≥ 200 CD4 cells/mm3 (OR = 4.82, 95% CI 2.44, 9.52, low strength of evidence). This result shows that poor adherence and CD4 count below < 200 cells/mm3 are significantly associated with treatment failure among HIV-positive patients on ART in a resource-limited setting. Conclusion: This review highlights that low CD4 counts and poor adherence to ART were associated to ART treatment failure. There is a need for healthcare workers and HIV program implementers to focus on patients who have these characteristics in order to prevent ART treatment failure. were resolved by consensus. We analyzed the data by doing a meta-analysis to pool the results for each outcome of interest.
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    Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
    (Elsevier, 2019-05-01) Feigin, Valery L.; Nichols, Emma; Alam, Tahiya; Bannick, Marlena S.; Beghi, Ettore; Blake, Natacha; Culpepper, William J.; Dorsey, E. Ray; Elbaz, Alexis; Ellenbogen, Richard G.; Fisher, James L.; Fitzmaurice, Christina; Giussani, Giorgia; Glennie, Linda; James, Spencer L.; Johnson, Catherine Owens; Kassebaum, Nicholas J.; Logroscino, Giancarlo; Marin, Benoit; Mountjoy-Venning, W. Cliff; Nguyen, Minh; Ofori-Asenso, Richard; Patel, Anoop P.; Piccininni, Marco; Roth, Gregory A.; Steiner, Timothy J.; Stovner, Lars Jacob; Szoeke, Cassandra E. I.; Theadom, Alice; Vollset, Stein Emil; Wallin, Mitchell Taylor; Wright, Claire; Zunt, Joseph Raymond; Abbasi, Nooshin; Abd-Allah, Foad; Abdelalim, Ahmed; Abdollahpour, Ibrahim; Aboyans, Victor; Abraha, Haftom Niguse; Acharya, Dilaram; Adamu, Abdu A.; Adebayo, Oladimeji M.; Adeoye, Abiodun Moshood; Adsuar, Jose C.; Afarideh, Mohsen; Agrawal, Sutapa; Ahmadi, Alireza; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Akinyemi, Rufus Olusola; Akseer, Nadia; Al-Eyadhy, Ayman; Al-Shahi salman, Rustam; Alahdab, Fares; Alene, Kefyalew Addis; Aljunid, Syed Mohamed; Altirkawi, Khalid; Alvis-Guzman, Nelson; Anber, Nahla Hamed; Antonio, Carl Abelardo T.; Arabloo, Jalal; Aremu, Olatunde; Arnlov, Johan; Asayesh, Hamid; Asghar, Rana Jawad; Atalay, Hagos Tasew; Awasthi, Ashish; Ayala Quintanilla, Beatriz Paulina; Ayuk, Tambe B.; Badawi, Alaa; Banach, Maciej; Banoub, Joseph Adel Mattar; Barboza, Miguel A.; Barker-Collo, Suzanne Lyn; Barnighausen, Till Winfried; Baune, Bernhard T.; Bedi, Neeraj; Behzadifar, Masoud; Behzadifar, Meysam; Bejot, Yannick; Bekele, Bayu Begashaw; Belachew, Abate Bekele; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Beuran, Mircea; Bhattacharyya, Krittika; Bhutta, Zulfiqar A.; Biadgo, Belete; Bijani, Ali; Bililign, Nigus; Bin Sayeed, Muhammad Shahdaat; Blazes, Christopher Kynrint; Brayne, Carol; Butt, Zahid A.; Campos-Nonato, Ismael R.; Cantu-Brito, Carlos; Car, Mate; Cardenas, Rosario; Carrero, Juan J.; Carvalho, Felix; Castaneda-Orjuela, Carlos A.; Castro, Franz; Catala-Lopez, Ferran; Cerin, Ester; Chaiah, Yazan; Chang, Jung-Chen; Chatziralli, Irini; Chiang, Peggy Pei-Chia; Christensen, Hanne; Christopher, Devasahayam J.; Cooper, Cyrus; Cortesi, Paolo Angelo; Costa, Vera M.; Criqui, Michael H.; Crowe, Christopher Stephen; Damasceno, Albertino Antonio Moura; Daryani, Ahmad; De la Cruz-Góngora, Vanessa; De La Hoz, Fernando Pio; De Leo, Diego; Degefa, Meaza Girma; Demoz, Gebre Teklemariam; Deribe, Kebede; Dharmaratne, Samath Dhamminda; Diaz, Daniel; Dinberu, Mesfin Tadese; Djalalinia, Shirin; Doku, David Teye; Dubey, Manisha; Dubljanin, Eleonora; Duken, Eyasu Ejeta; Edvardsson, David; El-Khatib, Ziad; Endres, Matthias; Endries, Aman Yesuf; Eskandarieh, Sharareh; Esteghamati, Alireza; Esteghamati, Sadaf; Farhadi, Farzaneh; Faro, Andre; Farzadfar, Farshad; Farzaei, Mohammad Hosein; Fatima, Batool; Fereshtehnejad, Seyed-Mohammad; Fernandes, Eduarda; Feyissa, Garumma Tolu; Filip, Irina; Fischer, Florian; Fukumoto, Takeshi; Ganji, Morsaleh; Gankpe, Fortune Gbetoho; Garcia-Gordillo, Miguel A,; Gebre, Abadi Kahsu; Gebremichael, Teklu Gebrehiwo; Gelaw, Belayneh K,; Geleijnse, Johanna M.; Geremew, Demeke; Gezae, Kebede Embaye; Ghasemi-Kasman, Maryam; Gidey, Mahari Y.; Gill, Paramjit Singh; Gill, Tiffany K.; Gnedovskaya, Elena V.; Goulart, Alessandra C.; Grada, Ayman; Grosso, Giuseppe; Guo, Yuming; Gupta, Rajeev; Haagsma, Juanita A.; Hagos, Tekleberhan B.; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hamadeh, Randah R.; Hamidi, Samer; Hankey, Graeme J.; Hao, Yuantao; Haro, Josep Maria; Hassankhani, Hadi; Hassen, Hamid Yimam; Havmoeller, Rasmus; Hay, Simon I.; Hegazy, Mohamed I.; Heidari, Behnam; Henok, Andualem; Heydarpour, Fatemeh; Hoang, Chi Linh; Hole, Michael K.; Homaie Rad, Enayatollah; Hosseini, Seyed Mostafa; Hu, Guoqing; Igumbor, Ehimario U.; Ilesanmi, Olayinka Stephen; Irvani, Seyed Sina Naghibi; Islam, Sheikh Mohammed Shariful; Jakovljevic, Mihajlo; Javanbakht, Mehdi; Jha, Ravi Prakash; Jobanputra, Yash B.; Jonas, Jost B.; Jozwiak, Jacek Jerzy; Jurisson, Mikk; Kahsay, Amaha; Kalani, Rizwan; Kalkonde, Yogeshwar; Kamil, Teshome Abegaz; Kanchan, Tanuj; Karami, Manoochehr; Karch, Andre; Karimi, Narges; Kasaeian, Amir; Kassa, Tesfaye Dessale; Kassa, Zemenu Yohannes; Kaul, Anil; Kefale, Adane Teshome; Keiyoro, Peter Njenga; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khalil, Ibrahim A.; Khan, Ejaz Ahmad; Khang, Young-Ho; Khazaie, Habibolah; Kiadaliri, Aliasghar A.; Kiirithio, Daniel N.; Kim, Anthony S.; Kim, Daniel; Kim, Young-Eun; Kim, Yun Jin; Kisa, Adnan; Kokubo, Yoshihiro; Koyanagi, Ai; Krishnamurthi, Rita V.; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kumar, Manasi; Lacey, Ben; Lafranconi, Alessandra; Lansingh, Van C.; Latifi, Arman; Leshargie, Cheru Tesema; Li, Shanshan; Liao, Yu; Linn, Shai; Lo, Warren David; Lopez, Jaifred Christian F.; Lorkowski, Stefan; Lotufo, Paulo A.; Lucas, Robyn M.; Lunevicius, Raimundas; Mackay, Mark T.; Mahotra, Narayan Bahadur; Majdan, Marek; Majdzadeh, Reza; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Manafi, Navid; Mansournia, Mohammad Ali; Mantovani, Lorenzo Giovanni; Marz, Winfried; Mashamba-Thompson, Tivani Phosa; Massenburg, Benjamin Ballard; Mate, Kedar K. V.; McAlinden, Colm; McGrath, John J.; Mehta, Varshil; Meier, Toni; Meles, Hagazi Gebre; Melese, Addisu; Memiah, Peter T. N.; Memish, Ziad A.; Mendoza, Walter; Mengistu, Desalegn Tadese; Mengistu, Getnet; Meretoja, Atte; Meretoja, Tuomo J.; Mestrovic, Tomislav; Miazgowski, Bartosz; Miazgowski, Tomasz; Miller, Ted R.; Mini, G. K.; Mirrakhimov, Erkin M.; Moazen, Babak; Mohajer, Bahram; Mezerji, Naser Mohammad Gholi; Mohammadi, Moslem; Mohammadi-Khanaposhtani, Maryam; Mohammadibakhsh, Roghayeh; Mohammadnia-Afrouzi, Mousa; Mohammed, Shafiu; Mohebi, Farnam; Mokdad, Ali H.; Monasta, Lorenzo; Mondello, Stefania; Moodley, Yoshan; Moosazadeh, Mahmood; Moradi, Ghobad; Moradi-Lakeh, Maziar; Moradinazar, Mehdi; Moraga, Paula; Moreno Velasquez, Ilais; Morrison, Shane Douglas; Mousavi, Seyyed Meysam; Muhammed, Oumer Sada; Muruet, Walter; Musa, Kamarul Imran; Mustafa, Ghulam; Naderi, Mehdi; Nagel, Gabriele; Naheed, Aliya; Naik, Gurudatta; Najafi, Farid; Nangia, Vinay; Negoi, Ionut; Negoi, Ruxandra Irina; Newton, Charles Richard James; Ngunjiri, Josephine W.; Nguyen, Cuong Tat; Nguyen, Long Hoang; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Nixon, Molly R.; Norrving, Bo; Noubiap, Jean Jacques; Nourollahpour Shiadeh, Malihe; Nyasulu, Peter S.; Ogbo, Felix Akpojene; Oh, In-Hwan; Olagunju, Andrew T.; Olagunju, Tinuke O.; Olivares, Pedro R.; Onwujekwe, Obinna E.; Oren, Eyal; Owolabi, Mayowa Ojo; P A, Mahesh; Pakpour, Amir H.; Pan, Wen-Harn; Panda-Jonas, Songhomitra; Pandian, Jeyaraj Durai; Patel, Sangram Kishor; Pereira, David M.; Petzold, Max; Pillay, Julian David; Piradov, Michael A.; Polanczyk, Guilherme V.; Polinder, Suzanne; Postma, Maarten J.; Poulton, Richie; Poustchi, Hossein; Prakash, Swayam; Prakash, V.; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rafiei, Alireza; Rahim, Fakher; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Muhammad Aziz; Rajati, Fatemeh; Ram, Usha; Ranta, Anna; Rawaf, David Laith; Rawaf, Salman; Reinig, Nickolas; Reis, Cesar; Renzaho, Andre M. N.; Resnikoff, Serge; Rezaeian, Shahab; Rezai, Mohammad Sadegh; Rios Gonzalez, Carlos Miguel; Roberts, Nicholas L. S.; Roever, Leonardo; Ronfani, Luca; Roro, Elias Merdassa; Roshandel, Gholamreza; Rostami, Ali; Sabbagh, Parisa; Sacco, Ralph L.; Sachdev, Perminder S.; Saddik, Basema; Safari, Hosein; Safari-Faramani, Roya; Safi, Sare; Safiri, Saeid; Sagar, Rajesh; Sahathevan, Ramesh; Sahebkar, Amirhossein; Sahraian, Mohammad Ali; Salamati, Payman; Salehi Zahabi, Saleh; Salimi, Yahya; Samy, Abdallah M.; Sanabria, Juan; Santos, Itamar S.; Santric Milicevic, Milena M.; Sarrafzadegan, Nizal; Sartorius, Benn; Sarvi, Shahabeddin; Sathian, Brijesh; Satpathy, Maheswar; Sawant, Arundhati R.; Sawhney, Monika; Schneider, Ione J. C.; Schottker, Ben; Schwebel, David C.; Seedat, Soraya, 1966-; Sepanlou, Sadaf G.; Shabaninejad, Hosein; Shafieesabet, Azadeh; Shaikh, Masood Ali; Shakir, Raad A.; Shams-Beyranvand, Mehran; Shamsizadeh, Morteza; Sharif, Mehdi; Sharif-Alhoseini, Mahdi; She, Jun; Sheikh, Aziz; Sheth, Kevin N.; Shigematsu, Mika; Shiri, Rahman; Shirkoohi, Reza; Shiue, Ivy; Siabani, Soraya; Siddiqi, Tariq J.; Sigfusdottir, Inga Dora; Sigurvinsdottir, Rannveig; Silberberg, Donald H.; Silva, Joao Pedro; Silveira, Dayane Gabriele Alves; Singh, Jasvinder A.; Sinha, Dhirendra Narain; Skiadaresi, Eirini; Smith, Mari; Sobaih, Badr Hasan; Sobhani, Soheila; Soofi, Moslem; Soyiri, Ireneous N.; Sposato, Luciano A.; Stein, Dan J.; Stein, Murray B.; Stokes, Mark A.; Sufiyan, Mu'awiyyah Babale; Sykes, Bryan L.; Sylaja, Pn; Tabarés-Seisdedos, Rafael; Te Ao, Braden James; Tehrani-Banihashemi, Arash; Temsah, Mohamad-Hani; Temsah, Omar; Thakur, Jarnail Singh; Thrift, Amanda G.; Topor-Madry, Roman; Tortajada-Girbés, Miguel; Tovani-Palone, Marcos Roberto; Tran, Bach Xuan; Tran, Khanh Bao; Truelsen, Thomas Clement; Tsadik, Afewerki Gebremeskel; Tudor Car, Lorainne; Ukwaja, Kingsley Nnanna; Ullah, Irfan; Usman, Muhammad Shariq; Uthman, Olalekan A.; Valdez, Pascual R.; Vasankari, Tommi Juhani; Vasanthan, Rajagopalan; Veisani, Yousef; Venketasubramanian, Narayanaswamy; Violante, Francesco S.; Vlassov, Vasily; Vosoughi, Kia; Vu, Giang Thu; Vujcic, Isidora S.; Wagnew, Fasil Shiferaw; Waheed, Yasir; Wang, Yuan-Pang; Weiderpass, Elisabete; Weiss, Jordan; Whiteford, Harvey A.; Wijeratne, Tissa; Winkler, Andrea Sylvia; Wiysonge, Charles Shey; Wolfe, Charles D. A.; Xu, Gelin; Yadollahpour, Ali; Yamada, Tomohide; Yano, Yuichiro; Yaseri, Mehdi; Yatsuya, Hiroshi; Yimer, Ebrahim M.; Yip, Paul; Yisma, Engida; Yonemoto, Naohiro; Yousefifard, Mahmoud; Yu, Chuanhua; Zaidi, Zoubida; Zaman, Sojib Bin; Zamani, Mohammad; Zandian, Hamed; Zare, Zohreh; Zhang, Yunquan; Zodpey, Sanjay; Naghavi, Mohsen; Murray, Christopher J. L.; Vos, Theo; Gupta, Rahul
    Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.
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    Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
    (Elsevier, 2019-11-26) James, Spencer L.; Theadom, Alice; Ellenbogen, Richard G.; Bannick, Marlena S.; Montjoy-Venning, Wcliff; Lucchesi, Lydia R.; Abbasi, Nooshin; Abdulkader, Rizwan; Abraha, Haftom Niguse; Adsuar, Jose C.; Afarideh, Mohsen; Agrawal, Sutapa; Ahmadi, Alireza; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Akinyemi, Rufus Olusola; Akseer, Nadia; Alahdab, Fares; Alebel, Animut; Alghnam, Suliman A.; Ali, Beriwan Abdulqadir; Alsharif, Ubai; Altirkawi, Khalid; Andrei, Catalina Liliana; Anjomshoa, Mina; Ansari, Hossein; Ansha, Mustafa Geleto; Antonio, Carl Abelardo T.; Appiah, Seth Christopher Yaw; Ariani, Filippo; Asefa, Nigus Gebremedhin; Asgedom, Solomon Weldegebreal; Atique, Suleman; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Ayuk, Tambe B.; Azzopardi, Peter S.; Badali, Hamid; Badawi, Alaa; Balalla, Shivanthi; Banstola, Amrit; Barker-Collo, Suzanne Lyn; Barnighausen, Till Winfried; Bedi, Neeraj; Behzadifar, Masoud; Behzadifar, Meysam; Bekele, Bayu Begashaw; Belachew, Abate Bekele; Belay, Yihalem Abebe; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Beuran, Mircea; Bhalla, Ashish; Bhaumik, Soumyadeeep; Bhutta, Zulfiqar A.; Biadgo, Belete; Biffino, Marco; Bijani, Ali; Bililign, Nigus; Birungi, Charles; Boufous, Soufiane; Brazinova, Alexandra; Brown, Allen W.; Car, Mate; Cardenas, Rosario; Carrero, Juan J.; Carvalho, Felix; Castaneda-Orjuela, Carlos A; Catala-Lopez, Ferran; Chaiah, Yazan; Champs, Ana Paula; Chang, Jung-Chen; Choi, Jee-Young J.; Christopher, Devasahayam J.; Cooper, Cyrus; Crowe, Christopher Stephen; Dandona, Lalit; Dandona, Rakhi; Daryani, Ahmad; Davitoiu, Dragos Virgil; Degefa, Meaza Girma; Demoz, Gebre Teklemariam; Deribe, Kebede; Djalalinia, Shirin; Do, Huyen Phuc; Doku, David Teye; Drake, Thomas M.; Dubey, Manisha; Dubljanin, Eleonora; El-Khatib, Ziad; Ofori-Asenso, Richard; Eskandarieh, Sharareh; Esteghamati, Alireza; Esteghamati, Sadaf; Faro, Andre; Farzadfar, Farshad; Farzaei, Mohammad Hosein; Fereshtehnejad, Seyed-Mohammad; Fernandes, Eduarda; Feyissa, Garumma Tolu; Filip, Irina; Fischer, Florian; Fukumoto, Takeshi; Ganji, Morasaleh; Gankpe, Fortune Gbetoho; Gebre, Abadi Kahsu; Gebrehiwot, Tsegaye Tewelde; Gezae, Kebede Embaye; Gopalkrishna, Gururaj; Goulart, Alessandra C.; Haagsma, Juanita A.; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hamadeh, Randah R.; Hamidi, Samer; Haro, Josep Maria; Hassankhani, Hadi; Hassen, Hamid Yimam; Havmoeller, Rasmus; Hawley, Caitlin; Hay, Simon I.; Hegazy, Mohamed I.; Hendrie, Delia; Henok, Andualem; Hibstu, Desalegn Tsegaw; Hoffman, Howard J.; Hole, Michael K.; Rad, Enayatollah Homaie; Hosseini, Seyed Mostafa; Hostiuc, Sorin; Hu, Guoqing; Hussen, Mamusha Aman; Ilesanmi, Olayinka Stephen; Irvani, Seyed Naghibi; Jakovljevic, Mihajlo; Jayaraman, Sudha; Jha, Ravi Prakash; Jonas, Jost B.; Jones, Kelly M.; Shushtari, Zahra Jorjoran; Jozwiak, Jacek Jerzy; Jürisson, Mikk; Kabir, Ali; Kahsay, Amaha; Kahssay, Molla; Kalani, Rizwan; Karch, Andre; Kasaeian, Amir; Kassa, Getachew Mullu; Kassa, Tesfaye Dessale; Kassa, Zemenu Yohannes; Kengne, Andre Pascal; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khalid, Nauman; Khalil, Ibrahim; Khan, Ejaz Ahmad; Khan, Muhammad Shahzeb; Khang, Young-Ho; Khazaie, Habibolah; Khoja, Abdullah T.; Khubchandani, Jagdish; Kiadaliri, Aliasghar A.; Kim, Daniel; Kim, Young-Eun; Kisa, Adnan; Koyanagi, Ai; Krohn, Kristopher J.; Defo, Barthelemy Kuate; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kumar, G. Anil; Kumar, Manasi; Lalloo, Ratilal; Lami, Faris Hasan; Lansingh, Van C.; Laryea, Dennis Odai; Latifi, Arman; Leshargie, Cheru Tesema; Levi, Miriam; Li, Shanshan; Liben, Misgan Legesse; Lotufo, Paulo A.; Lunevicius, Raimundas; Mahotra, Narayan Bahadur; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Manda, Ana-Laura; Mansournia, Mohammad Ali; Massenburg, Benjamin Ballard; Mate, Kedar K. V.; Mehndiratta, Man Mohan; Mehta, Varshil; Meles, Hagazi; Melese, Addisu; Memiah, Peter T. N.; Mendoza, Walter; Mengistu, Getnet; Meretoja, Atte; Meretoja, Tuomo J.; Mestrovic, Tomislav; Miazgowski, Tomasz; Miller, Ted R.; Mini, G. K.; Mirica, Andreea; Mirrakhimov, Andreea; Moazen, Babak; Mohammadi, Moslem; Mokdad, Ali H.; Molokhia, Mariam; Monasta, Lorenzo; Mondello, Stefania; Moosazadeh, Mahmood; Moradi, Ghobad; Moradi, Mahmoudreza; Moradi-Lakeh, Maziar; Moradinazar, Mehdi; Morrison, Shane Douglas; Moschos, Marilita M.; Mousavi, Seyyed Meysam; Murthy, Srinivas; Musa, Kamarul Imran; Mustafa, Ghulam; Naghavi, Mohsen; Naik, Gurudatta; Najafi, Farid; Nangia, Vinay; Nascimento, Bruno Ramos; Negoi, Ionut; Nguyen, Trang Huyen; Nichols, Emma; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Nyasulu, Peter S.; Ofori-Asenso, Richard; Ogbo, Felix Akpojene; Oh, In-Hwan; Okoro, Anselm; Olagunju, Andrew T.; Olagunju, Tinuke O.; Olivares, Pedro R.; Otstavnov, Stanislav S.; Owolabi, Mayowa Ojo; P A, Mahesh; Pakhale, Smita; Pandey, Achyut Raj; Pesudovs, Konrad; Pinilla-Monsalve, Gabriel D.; Polinder, Suzanne; Poustchi, Hossein; Prakash, Swayam; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rafiei, Alireza; Afarin Rahimi-Movaghar,; Vafa Rahimi-Movaghar,; Mahfuzar Rahman,; Muhammad Aziz Rahman,; Rajesh Kumar Rai,; Fatemeh Rajati,; Usha Ram,; David Laith Rawaf,; Salman Rawaf,; Robert C Reiner,; Cesar Reis,; Andre M N Renzaho,; Serge Resnikoff,; Satar Rezaei,; Shahab Rezaeian,; Leonardo Roever,; Luca Ronfani,; Gholamreza Roshandel,; Nobhojit Roy,; George Mugambage Ruhago,; Basema Saddik,; Hosein Safari,; Saeid Safiri,; Mohammad Ali Sahraian,; Payman Salamati,; Raphael de Freitas Saldanha,; Abdallah M Samy, Juan Sanabria,; João Vasco Santos,; Milena M M Santric Milicevic,; Benn Sartorius,; Maheswar Satpathy,; Ione J C Schneider,; David C Schwebel,; Sadaf G Sepanlou,; Hosein Shabaninejad,; Masood A Ali Shaikh,; Mehran Shams-Beyranvand,; Mehdi Sharif,; Mahdi Sharif-Alhoseini,; Sheikh Mohammed Shariful Islam,; Jun She,; Aziz Sheikh,; Jiabin Shen,; Kevin N Sheth,; Kenji Shibuya,; Mekonnen Sisay Shiferaw,; Mika Shigematsu,; Rahman Shiri,; Ivy Shiue,; Haitham Shoman,; Soraya Siabani,; Tariq J Siddiqi,; João Pedro Silva,; Dayane Gabriele Alves Silveira,; Dhirendra Narain Sinha,; Mari Smith,; Adauto Martins Soares Filho,; Soheila Sobhani,; Moslem Soofi,; Joan B Soriano,; Ireneous N Soyiri,; Dan J Stein,; Mark A Stokes,; Mu'awiyyah Babale Sufiyan,; Bruno F Sunguya,; Jacob E Sunshine,; Bryan L Sykes,; Cassandra E I Szoeke,; Rafael Tabarés-Seisdedos,; Braden James Te Ao,; Arash Tehrani-Banihashemi,; Merhawi Gebremedhin Tekle,; Mohamad-Hani Temsah,; Omar Temsah,; Roman Topor-Madry,; Miguel Tortajada-Girbés,; Bach Xuan Tran,; Khanh Bao Tran,; Lorainne Tudor Car,; Kingsley Nnanna Ukwaja,; Irfan Ullah,; Muhammad Shariq Usman,; Olalekan A Uthman,; Valdez, Pascual R; Vasankari, Tommi Juhani; Venketasubramanian, Narayanaswamy; Francesco S Violante,; Fasil Shiferaw Wagnew,; Yasir Waheed,; Yuan-Pang Wang,; Kidu Gidey Weldegwergs,; Andrea Werdecker,; Tissa Wijeratne,; Andrea Sylvia Winkler,; Grant M A Wyper,; Yuichiro Yano,; Mehdi Yaseri,; Yasin Jemal Yasin,; Pengpeng Ye,; Ebrahim M Yimer,; Paul Yip,; Engida Yisma,; Naohiro Yonemoto,; Seok-Jun Yoon,; Michael G Yost,; Mustafa Z Younis,; Mahmoud Yousefifard,; Chuanhua Yu,; Zoubida Zaidi,; Sojib Bin Zaman,; Mohammad Zamani,; Zerihun Menlkalew Zenebe,; Sanjay Zodpey,; Valery L Feigin,; Theo Vos,; Christopher J L Murray
    Background: Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30–30·30 million) new cases of TBI and 0·93 million (0·78–1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331–412) per 100 000 population for TBI and 13 (11–16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40–57·62 million) and of SCI was 27·04 million (24·98–30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (−0·2% [–2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (−3·6% [–7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0–10·4 million) YLDs and SCI caused 9·5 million (6·7–12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82–141) per 100 000 for TBI and 130 (90–170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments.
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    Implications of COVID-19 in high burden countries for HIV/TB : a systematic review of evidence
    (BMC (part of Springer Nature), 2020-10-09) Tamuzi, Jacques L.; Ayele, Birhanu T.; Shumba, Constance S.; Adetokunboh, Olatunji O.; Uwimana-Nicol, Jeannine; Haile, Zelalem T.; Inugu, Joseph; Nyasulu, Peter S.
    Background: The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the twenty-first century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management. Methods: We conducted an electronic search of potentially eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and July, 2020 in which SARSCoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB in adults. We screened titles, abstracts and full articles for eligibility. Descriptive and meta-analysis were done and results have been presented in graphs and tables. Results: After removing 95 duplicates, 58 out of 437 articles were assessed for eligibility, of which 14 studies were included for descriptive analysis and seven studies were included in the meta-analysis. Compared to the descriptive analysis, the meta-analysis showed strong evidence that current TB exposure was high-risk COVID-19 group (OR 1.67, 95% CI 1.06–2.65, P = 0.03). The pooled of COVID-19/TB severity rate increased from OR 4.50 (95% CI 1.12– 18.10, P = 0.03), the recovery rate was high among COVID-19 compared to COVID-19/TB irrespective of HIV status (OR 2.23, 95% CI 1.83–2.74, P < 0.001) and the mortality was reduced among non-TB group (P < 0.001). Conclusion: In summary, TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.
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    The incidence and mortality of yellow fever in Africa : a systematic review and meta‑analysis
    (BMC (part of Springer Nature), 2019) Nwaiwu, Akuoma U.; Musekiwa, Alfred; Tamuzi, Jacques L.; Sambala, Evanson Z.; Nyasulu, Peter S.
    Background: Understanding the occurrence of yellow fever epidemics is critical for targeted interventions and control efforts to reduce the burden of disease. We assessed data on the yellow fever incidence and mortality rates in Africa. Methods: We searched the Cochrane Library, SCOPUS, MEDLINE, CINAHL, PubMed, Embase, Africa-wide and Web of science databases from 1 January 1975 to 30th October 2020. Two authors extracted data from included studies independently and conducted a meta-analysis. Results: Of 840 studies identified, 12 studies were deemed eligible for inclusion. The incidence of yellow fever per 100,000 population ranged from < 1 case in Nigeria, < 3 cases in Uganda, 13 cases in Democratic Republic of the Congo, 27 cases in Kenya, 40 cases in Ethiopia, 46 cases in Gambia, 1267 cases in Senegal, and 10,350 cases in Ghana. Case fatality rate associated with yellow fever outbreaks ranged from 10% in Ghana to 86% in Nigeria. The mortality rate ranged from 0.1/100,000 in Nigeria to 2200/100,000 in Ghana. Conclusion: The yellow fever incidence rate is quite constant; in contrast, the fatality rates vary widely across African countries over the study period. Standardized demographic health surveys and surveillance as well as accurate diagnostic measures are essential for early recognition, treatment and control.