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      Prevalence of human visceral leishmaniasis and its risk factors in Eastern Africa: a systematic review and meta-analysis

      systematic-review

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          Abstract

          Introduction

          Visceral Leishmaniasis, also known as kala-azar, is a potentially fatal, neglected tropical disease caused by the protozoan parasite Leishmania and transmitted through infected sandflies. It is one of the major global public health problems and contributors to economic crisis among people. Though different studies investigated human visceral leishmaniasis in Eastern Africa, the findings were inconsistent and inconclusive enough, and there is no representative data on this devastating public health concern. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and risk factors associated with human visceral leishmaniasis in Eastern Africa.

          Methods

          The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) guidelines were followed for this study. Databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Web of Science, Cochrane Library, Google Scholar, Semantic Scholar, and Google were used to retrieve all the relevant articles. The search was carried out from 23 May 2024 to 17 July 2024. Data were analyzed using STATA 17 software to determine the pooled prevalence of human visceral leishmaniasis with a 95% confidence interval using a random-effects model.

          Result

          In this meta-analysis, thirty-nine articles with 40,367 study participants were included. The overall pooled prevalence of human visceral leishmaniasis in Eastern Africa was 26.16% [95%; CI: 19.96, 32.36%; I 2 = 99.67%; p = 0.00]. Gender, age, family size, presence of termite hill/mound, presence of cattle/domestic animals, outdoor sleeping, presence of VL infected family member/s, and presence of water source/pathway near home were the risk factors significantly associated with human visceral leishmaniasis.

          Conclusion

          The recorded pooled prevalence of human visceral leishmaniasis in Eastern Africa underscores the urgent need for comprehensive intervention strategies. This includes rigorous health education for residents, covering the disease’s cause, transmission, vector breeding sites, and prevention mechanisms.

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          Most cited references82

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Bias in meta-analysis detected by a simple, graphical test

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              Quantifying heterogeneity in a meta-analysis.

              The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity. Copyright 2002 John Wiley & Sons, Ltd.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2604979/overviewRole: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1563476/overviewRole: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2303950/overviewRole: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1403606/overviewRole: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1720213/overviewRole: Role: Role: Role: Role: Role:
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                21 November 2024
                2024
                : 12
                : 1488741
                Affiliations
                [1] 1Department of Nursing and Midwifery, Dessie Health Science College , Dessie, Ethiopia
                [2] 2Department of Environmental Health, College of Medicine and Health Sciences, Debre Markos University , Debre Markos, Ethiopia
                [3] 3Department of Environmental Health, College of Medicine and Health Sciences, Wollo University , Dessie, Ethiopia
                [4] 4National Centre for Epidemiology and Population Health, The Australian National University , Canberra, ACT, Australia
                Author notes

                Edited by: Ram Raghavan, University of Missouri, United States

                Reviewed by: Medhavi Sudarshan, Patliputra University, India

                Samiur Rahim, University of Dhaka, Bangladesh

                Agbajelola Victor, University of Missouri, United States

                *Correspondence: Abebe Kassa Geto, abebekassa2129@ 123456gmail.com
                Article
                10.3389/fpubh.2024.1488741
                11628699
                39659723
                a0f52dac-9a04-49ff-a930-612642d06267
                Copyright © 2024 Geto, Berihun, Berhanu, Desye and Daba.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 August 2024
                : 11 November 2024
                Page count
                Figures: 10, Tables: 3, Equations: 0, References: 93, Pages: 20, Words: 9652
                Funding
                The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
                Categories
                Public Health
                Systematic Review
                Custom metadata
                Infectious Diseases: Epidemiology and Prevention

                eastern africa,human,outdoor sleeping,termite hill,visceral leishmaniasis

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