Evidence map›Paper›PMID 37692980›Full record

SynthesisThe Pan African medical journal2023

Prevalence and predictors of virological failure in pediatric patients on HAART in sub-Saharan Africa: a systematic review and meta-analysis.

Nchimunya Machila, Liyali Libonda, Paul Habineza, Rachel Milomba Velu, Harvey Kakoma Kamboyi, Jacob Ndhlovu, Inonge Wamunyima, Monahani Makwibba Sinadambwe, Steward Mudenda, Cosmas Zyambo and 1 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The Pan African medical journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Nchimunya MachilaDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Liyali LibondaDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Paul HabinezaDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Rachel Milomba VeluCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Harvey Kakoma KamboyiDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Jacob NdhlovuDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Inonge WamunyimaDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Monahani Makwibba SinadambweDepartment of Women and Newborn, University Teaching Hospital, Lusaka, Zambia.
Steward MudendaDepartment of Pharmacy, School of Medicine, University of Zambia, Lusaka, Zambia.
Cosmas ZyamboDepartment of Community and Family Health, School of Public Health, University of Zambia, Lusaka, Zambia.
Flavien Nsoni BumbangiDepartment of Disease Control and Prevention, School of Medicine, Eden University, Lusaka, Zambia.
Centre for Infectious Disease Research in Zambia · ZM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Antiretroviral treatment failure has emerged as a challenge in the management of pediatric human immunodeficiency virus (HIV) patients, especially in resource-limited countries despite accessibility to Highly Active Antiretroviral Therapy (HAART). A systematic review and meta-analysis was conducted to synthesize virological failure (VF) prevalence and ascertain its predictors in children in sub-Saharan Africa. An electronic database search strategy was conducted from January to September 2021 on PubMed, EMBASE, SCOPUS, HINARI, and CINAHL. Further, manual searching was conducted on non-indexed journals. Utilizing the JASP© version 0.17.2 (2023) statistical software, a meta-analysis of pooled prevalence of VF was estimated using the standardized mean differences. Further, selection models were used to assess the risk of bias and heterogeneity. The pooled odds ratios were estimated for the respective studies reporting on predictors of VF. The overall pooled estimate of the prevalence of VF in sub-Saharan Africa among the sampled population was 29% (95% CI: 27.0-32.0; p<0.001). Predictors of VF were drug resistance (OR: 1.68; 95% CI: 0.88-2.49; p < 0.001), poor adherence (OR: 5.35; 95% CI: 5.26-5.45; p < 0.001), nevirapine (NVP)-based regimen (OR: 5.11; 95% CI: 4.66-5.56; p < 0.001), non-usage of cotrimoxazole prophylaxis (OR: 4.30; 95% CI: 4.13-4.47; p < 0.001), higher viral load at the initiation of antiretroviral therapy (ART) (OR: 244.32; 95% CI: 244.2-244.47; p <0.001), exposure to the prevention of mother to child transmission (PMTCT) (OR: 8.02; 95%CI: 7.58-8.46; p < 0.001), increased age/older age (OR: 3.37; 95% CI: 2.70-4.04; p < 0.001), advanced World Health Organization (WHO) stage (OR: 6.57; 95% CI: 6.17-6.98; p < 0.001), not having both parents as primary caregivers (OR: 3.01; 95% CI: 2.50-3.53; p < 0.001), and tuberclosis (TB) treatment (OR: 4.22; 95% CI: 3.68-4.76; p <0.001). The mean VF prevalence documented is at variance with studies in other developing countries outside the sub-Saharan region. The high prevalence of HIV cases contrasting with the limited expertise in the management of pediatric ART patients could explain this variance.

Indexed as

Antiretroviral Therapy, Highly ActiveInfectious Disease Transmission, VerticalAfrica South of the SaharaAnti-Retroviral AgentsChildFemaleHumansPrevalenceAnti-Retroviral AgentschildrenHAARTpediatricsprevalencesub-Saharan AfricaVirological failure

Identifiers

PMID37692980
PMCPMC10491719
OpenAlexW4381615701

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.