The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Moyo-Chilufya, Maureen; Maluleke, Kuhlula; Kgarosi, Kabelo; Muyoyeta, Monde; Hongoro, Charles; Musekiwa, Alfred

doi:10.1016/j.eclinm.2023.102255

Cited by 19 publications

(10 citation statements)

References 178 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of major depression among PLWH on ART was 16.3%. This finding is lower than that of other studies done in Africa in different places, Northern Tanzania, 20.9% [ 29 ], Ethiopia, 35.8% [ 30 ], Cameroon, 26.7% [ 31 ] and 30.4% in a recent systematic review and meta-analysis of non-communicable diseases burden among PLWH in sub-Saharan Africa [ 32 ]. However, our finding is similar to a systematic review and meta-analysis that reported the overall prevalence of major depression among PLWH in Sub-Saharan Africa using a diagnostic interview to be 15.3% [ 33 ].…”

Section: Discussionmentioning

confidence: 58%

Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors

Adedeji,

Ma,

Raji

et al. 2023

AIDS Res Ther

View full text Add to dashboard Cite

Major depression is the most common neuropsychiatric disorder among people living with HIV (PLWH) and is predictive of high morbidity and mortality among them. This study estimated the prevalence and explored factors associated with depression among PLWH in two rural secondary health facilities providing anti-retroviral therapy (ART) services in Southwestern Nigeria between September and December 2020. The Patient Health Questionnaire-9 (PHQ-9) was used to screen and identify PLWH aged 18 years or older with depression. Descriptive statistics, bivariate and multivariate analyses were performed with SPSS version 23. A total of 172 respondents were screened. The prevalence of depression was 16.3% (95% CI 11.1%, 22.7%). Mild, moderate, and moderately severe depression was identified in 17 (9.9%), 8(4.7%) and 3(1.7%) of the participants, respectively. One (0.6%) respondent had suicidal ideation. Of PLWH with any depression, 20/28(71.4%) were within the 40–59 years of age range. None of the participants was on antidepressants. The factor most associated with depression was hypertension, with adjusted odd ratios of 9.8(95% CI 3.5–27.3, p < 0.0001). The study highlights the importance of screening for the severity of depression among PLWH in rural hospitals providing ART services in Africa. PLWH with comorbid hypertension were more likely to suffer from some form of depression.

show abstract

Section: Discussionmentioning

confidence: 58%

Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors

Adedeji,

Ma,

Raji

et al. 2023

AIDS Res Ther

View full text Add to dashboard Cite

show abstract

“… 7 However, in the ART age, along with increasing life expectancy, there is increased vulnerability to NCDs, and multimorbidity remains. 5 , 6 PLWH have a higher incidence and prevalence of NCDs such as depression, cardiovascular disease (CVD), cervical cancer, diabetes, obesity, and hypercholesterolemia than people without HIV 1 , 8 – 12 ; CVD is one of the leading causes of non-AIDS morbidity and death among PLWH. 1 , 9 , 13 …”

Section: Introductionmentioning

confidence: 99%

“…In LMICs, there is a substantial burden of comorbid NCDs among PLWH, 14 – 16 especially NCDs, which are increasing among PLWH in sub-Saharan African (SSA) countries. 8 As the burden of NCDs among PLWH in LMICs increases, the quality of life and health benefits associated with HIV/AIDS are at risk. 15 , 16 As a result, PLWH may require frequent screening for NCD detection, diagnosis, and treatment.…”

Section: Introductionmentioning

confidence: 99%

Mapping evidence on barriers to and facilitators of diagnosing noncommunicable diseases among people living with human immunodeficiency virus in low- and middle-income countries in Africa: A scoping review

Badacho,

Woltamo,

Demissie

et al. 2024

SAGE Open Medicine

View full text Add to dashboard Cite

Objectives: To map the evidence on the barriers to and facilitators of diagnosing noncommunicable diseases among people living with HIV in low- and middle-income countries in Africa. Introduction: Noncommunicable diseases are increasing among people living with HIV. Thus, strengthened and sustained diagnosis of noncommunicable diseases through integrated noncommunicable diseases and HIV care is needed to improve patient outcomes. However, there is paucity of evidence on the barriers and facilitators diagnosing noncommunicable diseases among people living with HIV in low- and middle-income countries. Methods: The Arksey and O’Malley methodological framework was used. A comprehensive systematic search of academic databases (MEDLINE, Academic Search Complete, APA PsycInfo, CAB, and Health Source/Nursing) was performed via EBSCO search and PubMed. The articles were reviewed independently by three reviewers. The results were structured using Capability-Opportunity-Motivation-Behavior model and Theoretical Domains Framework. Results: A total of 152 articles were retrieved for full-text review. Forty-one articles met the inclusion criteria. The identified barriers were relevant to all the Capability-Opportunity-Motivation-Behavior constructs and 14 Theoretical Domains Framework domains. A lack of knowledge and awareness of noncommunicable diseases, fear of stigma, financial problems and out-of-pocket payments were the most cited patient-level barriers. Healthcare providers (knowledge and awareness gaps, skill and competence deficiencies, unwillingness, burnout, low motivation, and apathy) were frequently cited. Lack of equipment, noncommunicable disease medications and supply chain challenges, lack of integrated noncommunicable disease and HIV care, and shortage of trained healthcare providers were identified as health-system-level barriers. Conclusion: This scoping review is the first to identify barriers and facilitators using a theoretical framework. The most cited barriers include a lack of integrated HIV and noncommunicable disease care, equipment and logistics chain challenges for noncommunicable diseases, patients’ and healthcare providers’ lack of knowledge and awareness of noncommunicable diseases, and healthcare provider’s skill and competency deficiencies. Addressing these issues is crucial for improving patient outcomes and reducing the burden on healthcare providers and health systems.

show abstract

“…This is likely to impact people living with HIV and other infectious diseases. In addition, non-communicable diseases associated with HIV/AIDS, including hypertension, heart disease, diabetes, and cancer, continue to grow as the survival of HIV-infected people continues to improve with new effective treatments [ 3 , 4 ]. These current epidemics and potential future unknown epidemics and infodemics in SSA demand that institutions continue to invest not only in local research capacity to conduct research, but also in advancing capacity to use research, especially evidence synthesis, in healthcare decision making.…”

Section: Introductionmentioning

confidence: 99%

Building capacity for network meta-analysis in Sub-Saharan Africa: reflections and future direction

Rohwer,

Ngah,

Mavridis

et al. 2024

Syst Rev

View full text Add to dashboard Cite

Robust, relevant, comprehensive, and up-to-date evidence syntheses are the cornerstone for evidence-informed healthcare decisions. When considering multiple treatment options, network meta-analysis (NMA) systematic reviews play a key role in informing impactful decisions and clinical practice guidelines. However, the capacity and literacy to conduct NMA systematic reviews and interpret its results remains out of reach for many clinicians and review authors, especially in low-to-middle-income countries. Despite ample resources and guides, NMA capacity and training opportunities remain limited to non-existent in Sub-Saharan Africa. Towards solutions and strengthening evidence synthesis and NMA capacity in the Sub-Saharan African region, we describe and reflect on two courses that build NMA capacity and aim to address NMA literacy in Sub-Saharan Africa.The Primer in NMA systematic reviews aimed for participants to be able to find, appraise, interpret, and consider the use of NMA SRs of intervention effects. It is a 6-week online course for clinicians, policy-makers, and researchers wanting to learn more about using NMA systematic reviews. The Global NMA Masterclass workshop aimed for participants to be able to understand and apply pairwise and NMA in STATA and R, evaluate NMA assumptions and confidence in NMA results, and appropriately report NMA results. This course was offered over 5 weeks to clinicians, biostatisticians, and researchers with basic knowledge of epidemiology and biostatics. Although the bulk of learning occurred through self-study, we had weekly, synchronous question-and-answer sessions for both courses. Using relevant examples throughout the courses helped to enable an authentic learning environment.This was the first NMA training developed in Africa for Africa. Development of the courses was a collaborative effort from a multi-disciplinary team. Both NMA courses were well received and attended by a diverse group of participants spread across Sub-Saharan African countries. Participants felt the courses were applicable to their setting. Although most participants appreciated the benefits of online learning, we also experienced some challenges. There is great potential to conduct NMA systematic reviews in Sub-Saharan Africa. The NMA Primer and NMA workshop can play an essential role in expanding and developing NMA SR capacity and literacy in SSA.

show abstract

The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Cited by 19 publications

References 178 publications

Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors

Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors

Mapping evidence on barriers to and facilitators of diagnosing noncommunicable diseases among people living with human immunodeficiency virus in low- and middle-income countries in Africa: A scoping review

Building capacity for network meta-analysis in Sub-Saharan Africa: reflections and future direction

Contact Info

Product

Resources

About