Tesfa Dejenie Habtewold
Profile Url: tesfa-dejenie-habtewold
Researcher at University of Groningen, University Medical Center Groningen, Department of Epidemiology
Introduction To tackle the phenotypic heterogeneity of schizophrenia, data-driven methods are often applied to identify subtypes of its (sub)clinical symptoms though there is no systematic review. Aims To summarize the evidence from cluster- and trajectory-based studies of positive, negative and cognitive symptoms in patients with schizophrenia spectrum disorders, their siblings and healthy people. Additionally, we aimed to highlight knowledge gaps and point out future directions to optimize the translatability of cluster- and trajectory-based studies. Methods A systematic review was performed through searching PsycINFO, PubMed, PsycTESTS, PsycARTICLES, SCOPUS, EMBASE, and Web of Science electronic databases. Both cross-sectional and longitudinal studies published from 2008 to 2019, which reported at least two statistically derived clusters or trajectories were included. Two reviewers independently screened and extracted the data. Results Of 2,285 studies retrieved, 50 studies (17 longitudinal and 33 cross-sectional) conducted in 30 countries were selected for review. Longitudinal studies discovered two to five trajectories of positive and negative symptoms in patient, and four to five trajectories of cognitive deficits in patient and sibling. In cross-sectional studies, three clusters of positive and negative symptoms in patient, four clusters of positive and negative schizotypy in sibling, and three to five clusters of cognitive deficits in patient and sibling were identified. These studies also reported multidimensional predictors of clusters and trajectories. Conclusions Our findings indicate that (sub)clinical symptoms of schizophrenia are more heterogeneous than currently recognized. Identified clusters and trajectories can be used as a basis for personalized psychiatry.
Objective: The aim of this systematic review and meta-analysis was to investigate the association of gender of new-born, antenatal care (ANC) and postnatal care (PNC) with TIBF and EBF. Design: Systematic review and meta-analysis Methods: PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases systematically searched for all available literature, complemented by manual searches. Newcastle-Ottawa Scale (NOS) was used for quality check; Egger regression test for publication bias at p-value threshold ≤ 0.01; and Cochran Q X2 test and I2 statistics for heterogeneity. A meta-analysis using a weighted inverse variance random-effects model was performed. Results: Of 523 articles retrieved, 16 studies on TIBF and 23 on EBF fulfilled the eligibility criteria. Antenatal care (Odds ratio (OR) = 1.61, 95% CI 1.01 - 2.57) was significantly associated with TIBF but not gender of new-born (OR = 1.03, 95% CI 0.84 - 1.26). In addition, antenatal (OR = 2.25, 95% CI 1.63 - 3.10) and postnatal care (OR = 1.86, 95% CI 1.41 - 2.47) significantly associated with exclusive breastfeeding (EBF) but not gender of new-born (OR = 1.08, 95% CI 0.86 - 1.36). Conclusions: Optimal care during pregnancy and after birth is important to ensure adequate breastfeeding. In addition, there was no difference in breastfeeding between male and female new-born. This meta-analysis study provided evidence on breastfeeding practice and its associated factors in an Ethiopian context, which can be useful for cross-country and cross-cultural comparison and for breastfeeding improvement initiative in Ethiopia. Protocol registration and publication: CRD42017056768 and 10.1136/BMJOPEN-2017-017437
BackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa. MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Eggers regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out. ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations. ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.s Protocol registrationCRD42017079375