scholarly journals Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 491 ◽  
Author(s):  
Christina Oh ◽  
Emily C. Keats ◽  
Zulfiqar A. Bhutta
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Child Health ◽  
Low Birthweight ◽  
Grey Literature ◽  
Micronutrient Supplementation ◽  
Maternal Anemia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Almost two billion people are deficient in key vitamins and minerals, mostly women and children in low- and middle-income countries (LMICs). Deficiencies worsen during pregnancy due to increased energy and nutritional demands, causing adverse outcomes in mother and child, but could be mitigated by interventions like micronutrient supplementation. To our knowledge, this is the first systematic review that aimed to compile evidence from both efficacy and effectiveness trials, evaluating different supplementation interventions on maternal, birth, child health, and developmental outcomes. We evaluated randomized controlled trials and quasi-experimental studies published since 1995 in peer-reviewed and grey literature that assessed the effects of calcium, vitamin A, iron, vitamin D, and zinc supplementation compared to placebo/no treatment; iron-folic (IFA) supplementation compared to folic acid only; multiple micronutrient (MMN) supplementation compared to IFA; and lipid-based nutrient supplementation (LNS) compared to MMN supplementation. Seventy-two studies, which collectively involved 314 papers (451,723 women), were included. Meta-analyses showed improvement in several key birth outcomes, such as preterm birth, small-for-gestational age (SGA) and low birthweight with MMN supplementation, compared to IFA. MMN also improved child outcomes, including diarrhea incidence and retinol concentration, which are findings not previously reported. Across all comparisons, micronutrient supplementation had little to no effect on mortality (maternal, neonatal, perinatal, and infant) outcomes, which is consistent with other systematic reviews. IFA supplementation showed notable improvement in maternal anemia and the reduction in low birthweight, whereas LNS supplementation had no apparent effect on outcomes; further research that compares LNS and MMN supplementation could help understand differences with these commodities. For single micronutrient supplementation, improvements were noted in only a few outcomes, mainly pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D), and maternal serum zinc concentration (zinc). These findings highlight that micronutrient-specific supplementation should be tailored to specific groups or needs for maximum benefit. In addition, they further contribute to the ongoing discourse of choosing antenatal MMN over IFA as the standard of care in LMICs.

scholarly journals A systematic review of employment outcomes from youth skills training programmes in agriculture in low- and middle-income countries

Nature Food ◽  
2020 ◽  
Vol 1 (10) ◽  
pp. 605-619 ◽  
Author(s):  
W. H. Eugenie Maïga ◽  
Mohamed Porgo ◽  
Pam Zahonogo ◽  
Cocou Jaurès Amegnaglo ◽  
Doubahan Adeline Coulibaly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Skills Training ◽  
Urban Migration ◽  
Youth Engagement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Positive Effects ◽  
Training Programmes ◽  
Low And Middle Income

Abstract Engagement of youth in agriculture in low- and middle-income countries may offer opportunities to curb underemployment, urban migration, disillusionment of youth and social unrest, as well as to lift individuals and communities from poverty and hunger. Lack of education or skills training has been cited as a challenge to engage youth in the sector. Here we systematically interrogate the literature for the evaluation of skills training programmes for youth in low- and middle-income countries. Sixteen studies—nine quantitative, four qualitative and three mixed methods—from the research and grey literature documented the effects of programmes on outcomes relating to youth engagement, including job creation, income, productivity and entrepreneurship in agriculture. Although we find that skills training programmes report positive effects on our chosen outcomes, like previous systematic reviews we find the topic to chronically lack evaluation. Given the interest that donors and policymakers have in youth engagement in agriculture, our systematic review uncovers a gap in the knowledge of their effectiveness.

scholarly journals Evidence Based Dentistry among Dentists in Low and Middle Income Countries: A Systematic Review

2021 ◽  
Vol 5 (2) ◽  
pp. 129-136
Author(s):  
Irene Kida Minja ◽  
Edda Tandi Lwoga
Keyword(s):  
Systematic Review ◽  
Scientific Evidence ◽  
Grey Literature ◽  
Cochrane Library ◽  
Evidence Based ◽  
Middle Income ◽  
Hand Search ◽  
Middle Income Countries ◽  
Evidence Based Dentistry ◽  
Low And Middle Income

Purpose of this systematic review was to bring together studies of evidence-based practice among dentists in low- and middle-income countries, where its use has been reported to be limited. The protocol was registered in PROSPERO. Methodology: We searched the evidence (in English only) from medical databases including PubMed, EBSCO, The Cochrane Library, CINAHL, ScienceDirect, HINARI summon, and SCOPUS and Web of Science via Research4Life, grey literature, hand search from relevant articles, and augmented results on Google scholar.Published reports were retrieved from relevant websites and organizations. Studies included those that looked at key factors that facilitate or hinder Evidence Based Dentistry (EBD), as well as outcomes in terms of: knowledge, attitudes and skills of EB practice among dentists; and the methodology used and their relevance in future EBD strategies.Main focus was on dentists, as practitioners and faculty members. Studies on students and non-dental personnel were excluded.Findings:A total of 4568 records were retrieved and five potentially relevant articles were selected after title/abstract screening. Two articles were excluded after full text screening, and therefore Three papers were included in this review. The studies report limited knowledge,unsatisfactory attitude towards EBD and lowpractice of EBD and use of scientific evidence databases. None of the studies reported implementation of EBD nor evaluation thereof. The main barriers that constrained application of EBD ranged from lack of interest to infrastructural limitations. Originality: The current review showed that there is a need to strategised implementation of EBD in this region.

scholarly journals Impact of improved cookstoves on women’s and child health in low and middle income countries: a systematic review and meta-analysis

Thorax ◽  
2018 ◽  
Vol 73 (11) ◽  
pp. 1026-1040 ◽  
Author(s):  
Megha Thakur ◽  
Paulien A W Nuyts ◽  
Esther A Boudewijns ◽  
Javier Flores Kim ◽  
Timor Faber ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Child Health ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Quasi Experimental ◽  
Women And Children ◽  
Low And Middle Income

ObjectivesImproved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).DesignSystematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.SettingLMICsParticipantsWomen and childrenInterventionsImproved biomass cookstovesMain outcome measuresLow birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.ResultsWe identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11 560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11 061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI –13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.ConclusionImproved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.RegistrationPROSPERO: CRD42016033075

scholarly journals Effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in low and middle-income countries: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042788
Author(s):  
Chukwudi Arnest Nnaji ◽  
Paul Kuodi ◽  
Fiona M Walter ◽  
Jennifer Moodley
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Library ◽  
Middle Income ◽  
Cervical Cancers ◽  
Middle Income Countries ◽  
Timely Diagnosis ◽  
Evidence Summary ◽  
Low And Middle Income

IntroductionBreast and cervical cancers pose a major public health burden globally, with disproportionately high incidence, morbidity and mortality in low- and middle-income countries (LMICs). The majority of women diagnosed with cancer in LMICs present with late-stage disease, the treatment of which is often costlier and less effective. While interventions to improve the timely diagnosis of these cancers are increasingly being implemented in LMICs, there is uncertainty about their role and effectiveness. The aim of this review is to systematically synthesise available evidence on the nature and effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in LMICs.Methods and analysisA comprehensive search of published and relevant grey literature will be conducted. The following electronic databases will be searched: MEDLINE (via PubMed), Cochrane Library, Scopus, CINAHL, Web of Science and the International Clinical Trials Registry Platform (ICTRP). Evidence will be synthesised in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Two reviewers will independently screen the search outputs, select studies using predefined inclusion criteria and assess each included study for risk of bias. If sufficient data are available and studies are comparable in terms of interventions and outcomes, a meta-analysis will be conducted. Where studies are not comparable and a meta-analysis is not appropriate, a narrative synthesis of findings will be reported.Ethics and disseminationAs this will be a systematic review of publicly available data, with no primary data collection, it will not require ethical approval. Findings will be disseminated widely through a peer-reviewed publication and forums such as conferences, workshops and community engagement sessions. This review will provide a user-friendly evidence summary for informing further efforts at developing and implementing interventions for addressing delays in breast and cervical cancer diagnosis in LMICs.PROSPERO registration numberCRD42020177232.

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