Browsing by Author "Uthman, Olalekan A."

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    Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+ : an exploratory study
    (Dove Medical Press, 2016) Nachega, Jean B.; Skinner, Donald; Jennings, Larissa; Magidson, Jessica F.; Altice, Frederick L.; Burke, Jessica G.; Lester, Richard T.; Uthman, Olalekan A.; Knowlton, Amy R.; Cotton, Mark F.; Anderson, Jean R.; Theron, Gerhard B.
    ENGLISH SUMMARY : Objective: To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods: A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting: A community primary care clinic in Cape Town, South Africa. Participants: HIV-infected pregnant women. Main outcomes: Acceptability and feasibility of mHealth and cDOT interventions. Results: Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion: mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial.
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    The burden of mental disorders in the Eastern Mediterranean Region, 1990-2013
    (Public Library of Science, 2017) Charara, Raghid; Forouzanfar, Mohammad; Naghavi, Mohsen; Moradi-Lakeh, Maziar; Afshin, Ashkan; Vos, Theo; Daoud, Farah; Wang, Haidong; El Bcheraoui, Charbel; Khalil, Ibrahim; Hamadeh, Randah R.; Khosravi, Ardeshir; Rahimi-Movaghar, Vafa; Khader, Yousef; Al-Hamad, Nawal; Obermeyer, Carla Makhlouf; Rafay, Anwar; Asghar, Rana; Rana, Saleem M.; Shaheen, Amira; Abu-Rmeileh, Niveen M. E.; Husseini, Abdullatif; Abu-Raddad, Laith J.; Khoja, Tawfik; Al Rayess, Zulfa A.; AlBuhairan, Fadia S.; Hsairi, Mohamed; Alomari, Mahmoud A.; Ali, Raghib; Roshandel, Gholamreza; Terkawi, Abdullah Sulieman; Hamidi, Samer; Refaat, Amany H.; Westerman, Ronny; Kiadaliri, Aliasghar Ahmad; Akanda, Ali S.; Ali, Syed Danish; Bacha, Umar; Badawi, Alaa; Bazargan-Hejazi, Shahrzad; Faghmou, Imad A. D.; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Jonas, Jost B.; Defo, Barthelemy Kuate; Mehari, Alem; Omer, Saad B.; Pourmalek, Farshad; Uthman, Olalekan A.; Mokdad, Ali A.; Maalouf, Fadi T.; Abd-Allah, Foad; Akseer, Nadia; Arya, Dinesh; Borschmann, Rohan; Brazinova, Alexandra; Brugha, Traolach S.; Catala-Lopez, Ferran; Degenhardt, Louisa; Ferrari, Alize; Haro, Josep Maria; Horino, Masako; Hornberger, John C.; Huang, Hsiang; Kieling, Christian; Kim, Daniel; Kim, Yunjin; Knudsen, Ann Kristin; Mitchell, Philip B.; Patton, George; Sagar, Rajesh; Satpathy, Maheswar; Savuon, Kim; Seedat, Soraya; Shiue, Ivy; Skogen, Jens Christoffer; Stein, Dan J.; Tabb, Karen M.; Whiteford, Harvey A.; Yip, Paul; Yonemoto, Naohiro; Murray, Christopher J. L.; Mokdad, Ali H.
    The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25–49 age group, with a peak in the 35–39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of diseases in the region.
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    Citation classics in systematic reviews and meta-analyses : who wrote the top 100 most cited articles?
    (Public Library of Science, 2013) Uthman, Olalekan A.; Okwundu, Charles I.; Young, Taryn; Wiysonge, Charles S.; Clarke, Aileen
    Background Systematic reviews of the literature occupy the highest position in currently proposed hierarchies of evidence. The aims of this study were to assess whether citation classics exist in published systematic review and meta-analysis (SRM), examine the characteristics of the most frequently cited SRM articles, and evaluate the contribution of different world regions. Methods The 100 most cited SRM were identified in October 2012 using the Science Citation Index database of the Institute for Scientific Information. Data were extracted by one author. Spearman’s correlation was used to assess the association between years since publication, numbers of authors, article length, journal impact factor, and average citations per year. Results Among the 100 citation classics, published between 1977 and 2008, the most cited article received 7308 citations and the least-cited 675 citations. The average citations per year ranged from 27.8 to 401.6. First authors from the USA produced the highest number of citation classics (n=46), followed by the UK (n=28) and Canada (n=15). The 100 articles were published in 42 journals led by the Journal of the American Medical Association (n=18), followed by the British Medical Journal (n=14) and The Lancet (n=13). There was a statistically significant positive correlation between number of authors (Spearman’s rho=0.320, p=0.001), journal impact factor (rho=0.240, p=0.016) and average citations per year. There was a statistically significant negative correlation between average citations per year and year since publication (rho = -0.636, p=0.0001). The most cited papers identified seminal contributions and originators of landmark methodological aspects of SRM and reflect major advances in the management of and predisposing factors for chronic diseases. Conclusions Since the late 1970s, the USA, UK, and Canada have taken leadership in the production of citation classic papers. No first author from low or middle-income countries (LMIC) led one of the most cited 100 SRM.
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    Does economic growth reduce childhood stunting? a multicountry analysis of 89 demographic and health surveys in sub-Saharan Africa
    (BMJ Publishing, 2020-01) Yaya, Sanni; Uthman, Olalekan A.; Kunnuji, Michael; Navaneetham, Kannan; Akinyemi, Joshua O.; Kananura, Rornald Muhumuza; Adjiwanou, Visseho; Adetokunboh, Olatunji; Bishwajit, Ghose
    Background: There is mixed evidence and lack of consensus on the impact of economic development on stunting, and likewise there is a dearth of empirical studies on this relationship in the case of sub-Saharan Africa. Thus, this paper examines whether economic growth is associated with childhood stunting in low-income and middle-income sub-Saharan African countries. Methods: We analysed data from 89 Demographic and Health Surveys conducted between 1987 and 2016 available as of October 2018 using multivariable multilevel logistic regression models to show the association between gross domestic product (GDP) per capita and stunting. We adjusted the models for child’s age, survey year, child’s sex, birth order and country random effect, and presented adjusted and unadjusted ORs. Results: We included data from 490 526 children. We found that the prevalence of stunting decreased with increasing GDP per capita (correlation coefficient=−0.606, p<0.0001). In the unadjusted model for full sample, for every US$1000 increase in GDP per capita, the odds of stunting decreased by 23% (OR=0.77, 95% CI 0.76 to 0.78). The magnitude of the association between GDP per capita and stunting was stronger among children in the richest quintile. After adjustment was made, the association was not significant among children from the poorest quintile. However, the magnitude of the association was more pronounced among children from low-income countries, such that, in the model adjusted for child’s age, survey year, child’s sex, birth order and country random effect, the association between GDP per capita and stunting remained statistically significant; for every US$1000 increase in GDP per capita, the odds of stunting decreased by 12% (OR=0.88, 95% CI 0.87 to 0.90). Conclusion: There was no significant association between economic growth and child nutritional status. The prevalence of stunting decreased with increasing GDP per capita. This was more pronounced among children from the richest quintile. The magnitude of the association was higher among children from low-income countries, suggesting that households in the poorest quintile were typically the least likely to benefit from economic gains. The findings could serve as a building block needed to modify current policy as per child nutrition-related programmes in Africa.
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    Factors that affect the uptake of community-based health insurance in low-income and middle-income countries : a systematic protocol
    (BMJ Publishing Group, 2014) Adebayo, Esther F.; Ataguba, John E.; Uthman, Olalekan A.; Okwundu, Charles I.; Lamont, Kim T.; Wiysonge, Charles S.
    ENGLISH SUMMARY : Introduction: Many people residing in low-income and middle-income countries (LMICs) are regularly exposed to catastrophic healthcare expenditure. It is therefore pertinent that LMICs should finance their health systems in ways that ensure that their citizens can use needed healthcare services and are protected from potential impoverishment arising from having to pay for services. Ways of financing health systems include government funding, health insurance schemes and out-of-pocket payment. A health insurance scheme refers to pooling of prepaid funds in a way that allows for risks to be shared. The health insurance scheme particularly suitable for the rural poor and the informal sector in LMICs is community-based health insurance (CBHI), that is, insurance schemes operated by organisations other than governments or private for-profit companies. We plan to search for and summarise currently available evidence on factors associated with the uptake of CBHI, as we are not aware of previous systematic reviews that have looked at this important topic. Methods: This is a protocol for a systematic review of the literature. We will include both quantitative and qualitative studies in this review. Eligible quantitative studies include intervention and observational studies. Qualitative studies to be included are focus group discussions, direct observations, interviews, case studies and ethnography. We will search EMBASE, PubMed, Scopus, ERIC, PsycInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL and the Cochrane Library for eligible studies available by 31 October 2013, regardless of publication status or language of publication. We will also check reference lists of included studies and proceedings of relevant conferences and contact researchers for eligible studies. Two authors will independently screen the search output, select studies and extract data, resolving discrepancies by consensus and discussion. Qualitative data will be extracted using standardised data extraction tools adapted from the Critical Appraisal Skills Program (CASP) qualitative appraisal checklist and put together in a thematic analysis where applicable. We will statistically pool data from quantitative studies in a meta-analysis; but if included quantitative studies differ significantly in study settings, design and/or outcome measures, we will present the findings in a narrative synthesis. This protocol has been registered with PROSPERO (ID=CRD42013006364). Dissemination: Recommendations will be made to health policy makers, managers and researchers in LMICs to help inform them on ways to strengthen and increase the uptake of CBHI.
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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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    The impact of mass media interventions on tuberculosis awareness, health-seeking behaviour and health service utilisation : a systematic review protocol
    (BMJ Publishing Group, 2014-12) Nglazi, Mweete D.; Bekker, Linda-Gail; Wood, Robin; Shey, Muki S.; Uthman, Olalekan A.; Wiysonge, Charles S.
    Introduction: Tuberculosis (TB) is a serious public health problem in many parts of the world. Strategies to curb the spread of TB must match the multifaceted nature of the epidemic. The use of mass media is one of the important strategies in communicating behavioural change in relation to TB prevention and the treatment. However, the benefits of this intervention are unclear. We, therefore, plan to conduct a systematic review on the effects of mass media interventions on TB awareness, health-seeking behaviour and health service utilisation. Methods: and analysis We will preferably include randomised controlled trials (RCTs) in this systematic review. However, non-randomised studies will be included if there is an inadequate number of RCTs. We will perform electronic searches in PubMed, Scopus and other databases, along with manual searches. Articles written (or translated) in English and French and published between 1 January 1980 and 31 October 2013 will be eligible for inclusion in this review. The primary outcomes will be TB knowledge, attitudes and awareness, healthcare-seeking behaviour and service utilisation. The secondary outcomes will include stigma and discrimination against people with TB and the costs of the interventions. We will investigate clinical and statistical heterogeneity and pool studies judged to be clinically and statistically homogeneous. Relative risks will be calculated for dichotomous outcomes and mean differences for continuous outcomes, both with their corresponding 95% CIs. Ethics: and dissemination The systematic review will use data that is not linked to individuals. The review findings may have implications for clinical practice and future research, and will be disseminated electronically and in print through peer-reviewed publications.
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    Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors
    (BioMed Central, 2017-03) Adedokun, Sulaimon T.; Uthman, Olalekan A.; Adekanmbi, Victor T.; Wiysonge, Charles S.
    ENGLISH SUMMARY : Background: Under-five mortality remains high in sub-Saharan Africa despite global decline. One quarter of these deaths are preventable through interventions such as immunization. The aim of this study was to examine the independent effects of individual-, community- and state-level factors on incomplete childhood immunization in Nigeria, which is one of the 10 countries where most of the incompletely immunised children in the world live. Methods: The study was based on secondary analyses of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (DHS). Multilevel multivariable logistic regression models were applied to the data on 5,754 children aged 12–23 months who were fully immunized or not (level 1), nested within 896 communities (level 2) from 37 states (level 3). Results: More than three-quarter of the children (76.3%) were not completely immunized. About 83% of children of young mothers (15–24 years) and 94% of those whose mothers are illiterate did not receive full immunization. In the fully adjusted model, the chances of not being fully immunized reduced for children whose mothers attended antenatal clinic (adjusted odds ratio [aOR] = 0.49; 95% credible interval [CrI] = 0.39–0.60), delivered in health facility (aOR = 0.62; 95% CrI = 0.51–0.74) and lived in urban area (aOR = 0.66; 95% CrI = 0.50–0.82). Children whose mothers had difficulty getting to health facility (aOR = 1.28; 95% CrI = 1.02–1.57) and lived in socioeconomically disadvantaged communities (aOR = 2.93; 95% CrI = 1.60–4.71) and states (aOR = 2.69; 955 CrI =1.37–4.73) were more likely to be incompletely immunized. Conclusions: This study has revealed that the risk of children being incompletely immunized in Nigeria was influenced by not only individual factors but also community- and state-level factors. Interventions to improve child immunization uptake should take into consideration these contextual characteristics.
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    Individual and contextual correlates of mosquito net use among women in Nigeria
    (BMC (part of Springer Nature), 2020-04-07) Adedokun, Sulaimon T.; Uthman, Olalekan A.
    Background: Malaria has been described as an urgent public health priority with almost half of the world’s population being at risk. Use of insecticide-treated nets is considered one of the effective ways of preventing malaria. Nigeria, which is ranked among the five countries that are responsible for almost half of the global malaria cases, has less than half of its women population using mosquito nets. This study examined the effects of individual and contextual factors on the use of mosquito nets among women of reproductive age in Nigeria. Methods: This study used data obtained from 2015 Nigeria Malaria Indicator Survey (NMIS) which involved 6048 women aged 15–49 who possessed at least one mosquito net. Multilevel binary logistic regression models were applied in the multivariable analysis. Results: About 53% of the women used mosquito nets with more than 60% of uneducated and poor women in this category. The use of mosquito nets was significantly associated with being from poor households, having knowledge about the cause of malaria, having access to malaria messages, possessing knowledge about the efficacy of malaria prevention drugs during pregnancy, having knowledge about the importance of tests to detect malaria, maintaining small household size and living in the most socioeconomically disadvantaged communities and states. Conclusions: The study revealed that mosquito net use among women in Nigeria is affected by individual and contextual factors. It is important for policy makers to design a mosquito-net-use model which would take individual and contextual factors into consideration.
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    A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria : findings from the pre-implementation phase of a collaborative quality improvement programme
    (Public Library of Science, 2019-07-10) Adamu, Abdu A.; Uthman, Olalekan A.; Gadanya, Muktar A.; Adetokunboh, Olatunji O.; Wiysonge, Charles S.
    Background: We aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0–23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria. Methods: This cross-sectional study was conducted in the pre-implementation phase of a quality improvement programme. One-stage cluster sampling technique was employed. Data were collected from caregivers of children aged 0–23 months in ten randomly selected PHC facilities in Nassarawa Local Government Area of Kano State. Semi-structured, interviewer administered questionnaires were used. Frequencies and percentages were used to summarize the data. Multilevel logistic regression model with fixed effect and random effect component was fitted to obtain measures of association and variation respectively. Results: Caregivers of 675 children responded. Among these children, the prevalence of MOV (for at least one antigen) was 36.15%. MOV (for individual antigens) was highest for inactivated polio vaccine followed by measles vaccine. The random effect model yielded an intraclass correlation coefficient of 9.60% for the empty model. The fixed effect model revealed that MOV was more likely among children that were accompanying a caregiver to the health facility (OR = 2.86, 95%CrI: 1.28 to 5.80) compared to those that were visiting the health facility for medical consultation. Failure to receive vaccination on the day of health facility visit (OR = 2.32, 95%CrI: 1.12 to 4.12) and visiting a clinic with three or more vaccinators (OR = 12.91, 95%CrI: 4.82 to 27.14) increased the likelihood of MOV. Conclusion: The study identified important local factors that are responsible for MOV which can be addressed in the QI programme.
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    A systematic review of factors that affect uptake of community-based health insurance in low-income and middle income countries
    (BioMed Central, 2015-12) Adebayo, Esther F.; Uthman, Olalekan A.; Wiysonge, Charles S.; Stern, Erin A.; Lamont, Kim T.; Ataguba, John E.
    Background: Low-income and middle-income countries (LMICs) have difficulties achieving universal financial protection, which is primordial for universal health coverage. A promising avenue to provide universal financial protection for the informal sector and the rural populace is community-based health insurance (CBHI). We systematically assessed and synthesised factors associated with CBHI enrolment in LMICs. Methods: We searched PubMed, Scopus, ERIC, PsychInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL, Cochrane Library, conference proceedings, and reference lists for eligible studies available by 31 October 2013; regardless of publication status. We included both quantitative and qualitative studies in the review. Results: Both quantitative and qualitative studies demonstrated low levels of income and lack of financial resources as major factors affecting enrolment. Also, poor healthcare quality (including stock-outs of drugs and medical supplies, poor healthcare worker attitudes, and long waiting times) was found to be associated with low CBHI coverage. Trust in both the CBHI scheme and healthcare providers were also found to affect enrolment. Educational attainment (less educated are willing to pay less than highly educated), sex (men are willing to pay more than women), age (younger are willing to pay more than older individuals), and household size (larger households are willing to pay more than households with fewer members) also influenced CBHI enrolment. Conclusion: In LMICs, while CBHI schemes may be helpful in the short term to address the issue of improving the rural population and informal workers’ access to health services, they still face challenges. Lack of funds, poor quality of care, and lack of trust are major reasons for low CBHI coverage in LMICs. If CBHI schemes are to serve as a means to providing access to health services, at least in the short term, then attention should be paid to the issues that militate against their success.
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    The use of supplementary immunisation activities to improve uptake of current and future vaccines in low-income and middle-income countries : a systematic review protocol
    (BMJ Publishing Group, 2014-01) Kagina, Benjamin M.; Wiysonge, Charles S.; Machingaidze, Shingai; Abdullahi, Leila H.; Adebayo, Esther; Uthman, Olalekan A.; Hussey, Gregory D.
    ENGLISH SUMMARY : Introduction: Immunisation coverage data in low-income and middle-income countries (LMICs) suggest that more strategies need to be implemented to achieve and sustain optimal vaccine uptake. Among possible strategies to improve immunisation coverage are supplementary immunisation activities (SIAs). We are therefore interested in conducting a systematic review to assess whether SIAs complement routine immunisation programmes to improve vaccination coverage and prevent disease outbreaks. Methods: Our systematic review will focus on studies conducted in LMICs. With the help of an information specialist, we will search for eligible studies in PubMed, Web of Science, Scopus, Africa-Wide, Cochrane Library, WHOLIS, CINAHL, PDQ-Evidence as well as reference lists of relevant publications. Additionally, we will contact relevant organisations such as WHO and GAVI. Two authors will independently extract data from eligible studies and independently assess risk of bias by assessing the adequacy of study characteristics. The primary meta-analysis will use random effects models due to expected interstudies heterogeneity. Dichotomous data will be analysed using relative risk and continuous data using weighted mean differences (or standardised mean differences), both with 95% CIs. Discussion: The findings from this systematic review will be discussed in the context of strengthening routine childhood immunisation services, routine adolescent immunisation services and introduction of future vaccines against tuberculosis and HIV/AIDS. Study strengths: Unbiased selection of many studies conducted in different settings. This will strengthen the validity of the review results. Study limitations: Heterogeneity of the study settings of the low-income, lower-middle-income and upper-middle-income countries as well as heterogeneity in study designs.