Prevalence, incidence and aetiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis protocol

Abstract

IntroductionThere are no data summarising the epidemiology of pulmonary hypertension (PH) among adults residing in Africa. Establishment of accurate epidemiological data on PH in this region may guide decision-making toward interventions to curb the burden of PH in Africa. The aim of this systematic review is to determine the prevalence, incidence and aetiologies of PH among people residing in Africa.Methods and analysisThis systematic review and meta-analysis will follow the MOOSE guidelines for reporting. Relevant abstracts published until 30 September 2016 will be searched in PubMed/Medline, EMBASE (Excerpta Medica Database), African Journals Online and Africa Index Medicus. Full texts of eligible studies will then be accessed through PubMed, Google Scholar, HINARI and the respective journals’ websites. Relevant unpublished papers and conference proceedings will also be checked. Data will be analysed using STATA version 13 software. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate of the prevalence/incidence and aetiologies of PH across studies. Heterogeneity of studies will be evaluated by the χ2 test on Cochrane’s Q statistic. Funnel plot analysis and Egger’s test will be done to detect publication bias. Results will be presented by geographical region (central, eastern, northern, southern and western Africa). Ethics and disseminationThe current study is based on published data; ethical approval is, therefore, not required. This review will guide policy, practice and research by providing information on the magnitude of PH among people residing in Africa. Findings will be presented in evidence tables of individual studies as well as in summary tables. The final report of this systematic review, in the form of a scientific paper, will be published in a peer-reviewed journal. Furthermore, findings will be presented at conferences and submitted to relevant health authorities.Review registration numberPROSPERO CRD42016049351.

Hypertension and Metabolic Syndrome in Persons with HIV

“…Some have shown that central obesity and overweight increased the risk of hypertension and MetS in PWH as they do in the general population [9•], whereas others reported that nadir CD4 T cell counts were also associated with hypertension in European [35] and African [34•] PWH, a finding specific to HIV populations. In addition to HIVrelated inflammation and detrimental effects of ART on adipocyte health and lipid metabolism, specific components of the virus such as the negative factor (Nef) protein, transcription protein (Tat), and glycoprotein 120 may contribute to the link between MetS and hypertension in PWH, perhaps superimposed on individual genetic predisposition [36][37][38].…”

Prevalence of Hypertension among HIV/AIDS Patients Attending a Tertiary Hospital in North-East Nigeria

“…The introduction and subsequent scaling up of highly active antiretroviral therapy HAART coverage has remarkably reduced HIV associated morbidity and mortality and increased the life expectancy of people living with HIV (PLWH). However, this gain seems to be counteracted by the rising incidence of hypertension among this PLWH [2]. Furthermore, contributing to this trend is the phenomenon of epidemiologic transition.…”

“…Globally, there is a growing trend of cardiovascular outcomes and metabolic complications in the HIV infected population. Accounting for 10% of non-AIDs related mortality, CVD are a major cause of morbidity and mortality amongst HIV subjects [2]. The lifelong CVD risk that trails HIV infection provides the premise for such study [5].…”