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      Strengthening literature search strategies for systematic reviews reporting population health in the Middle East and North Africa: A meta‐research study

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          Abstract

          Objective

          In the Middle East and North Africa (MENA), data are produced in languages other than English and available through gray literature sources. We assessed the comprehensiveness of literature search strategies of systematic reviews (SRs) reporting population health primary data on MENA.

          Methods

          Utilizing the registered protocol (PROSPERO CRD42017076736), we conducted a meta‐research analysis on a cohort of SRs (systematic PubMed search: from 2008 to 2016) and evaluated their search strategies following AMSTAR recommendations.

          Results

          A total of 379 SRs were included. Few SRs (10.3%, = 39) conducted a comprehensive literature search including at least two databases, reference lists of included primary studies, gray literature sources, and no language restriction. Nevertheless, 90.5% ( = 343) searched at least two databases and 67.0% ( = 254) searched gray literature sources. Authors from MENA searched statistically more for gray literature than authors from Western countries ( = 0.022). Reference lists of the included studies were searched in 40.4% ( = 153) of the SRs. Searching the reference lists was positively associated with searching for gray literature ( < 0.001). Only 38.8% ( = 147) of the SRs had no language restriction or searched in English and in at least one language relevant to MENA, whereas 27.2% ( = 103) did not report this information.

          Conclusions

          Literature searches for SRs reporting population health data on MENA were limited in reporting quality, language restrictions, and lack of reference list searches. This was probably due to lack of adherence to the reporting guidelines. To ensure compilation of optimum evidence, expanding literature searches to reference list search and for additional languages relevant to MENA are required.

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          Most cited references 11

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          PROSPERO at one year: an evaluation of its utility

          Background PROSPERO, an international prospective register of systematic review protocols in health and social care, was launched in February 2011. After one year of operation we describe access and use, explore user experience and identify areas for future improvement. Methods We collated administrative data and web statistics and conducted an online survey of users’ experiences. Results On 21 February 2012, there were 1,076 registered users and 359 registration records published on PROSPERO. The database usage statistics demonstrate the international interest in PROSPERO with high access around the clock and around the world. Based on 232 responses from PROSPERO users (response rate 22%), almost all respondents found joining and navigation was easy or very easy (99%); turn round time was good or excellent (96%); and supporting materials provided were helpful or very helpful (80%). The registration fields were found by 80% to be relevant to their review; 99% rated their overall experience of registering with PROSPERO as good or excellent. Most respondents (81%) had a written protocol before completing the registration form and 19% did not. The majority, 136 (79%), indicated they completed the registration form in 60 minutes or less. Of those who expressed an opinion, 167 (87%) considered the time taken to be about right. Conclusions The first year of PROSPERO has shown that registration of systematic review protocols is feasible and not overly burdensome for those registering their reviews. The evaluation has demonstrated that, on the whole, survey respondents are satisfied and the system allows registration of protocol details in a straightforward and acceptable way. The findings have prompted some changes to improve user experience and identified some issues for future consideration.
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            The Epidemiology of Hepatitis C Virus in the Fertile Crescent: Systematic Review and Meta-Analysis

            Objective To characterize hepatitis C virus (HCV) epidemiology in countries of the Fertile Crescent region of the Middle East and North Africa (MENA), namely Iraq, Jordan, Lebanon, Palestine, and Syria. Methods We systematically reviewed and synthesized available records of HCV incidence and prevalence following PRISMA guidelines. Meta-analyses were implemented using a DerSimonian-Laird random effects model with inverse weighting to estimate the country-specific HCV prevalence among the various at risk population groups. Results We identified eight HCV incidence and 240 HCV prevalence measures in the Fertile Crescent. HCV sero-conversion risk among hemodialysis patients was 9.2% in Jordan and 40.3% in Iraq, and ranged between 0% and 3.5% among other populations in Iraq over different follow-up times. Our meta-analyses estimated HCV prevalence among the general population at 0.2% in Iraq (range: 0–7.2%; 95% CI: 0.1–0.3%), 0.3% in Jordan (range: 0–2.0%; 95% CI: 0.1–0.5%), 0.2% in Lebanon (range: 0–3.4%; 95% CI: 0.1–0.3%), 0.2% in Palestine (range: 0–9.0%; 95% CI: 0.2–0.3%), and 0.4% in Syria (range: 0.3–0.9%; 95% CI: 0.4–0.5%). Among populations at high risk, HCV prevalence was estimated at 19.5% in Iraq (range: 0–67.3%; 95% CI: 14.9–24.5%), 37.0% in Jordan (range: 21–59.5%; 95% CI: 29.3–45.0%), 14.5% in Lebanon (range: 0–52.8%; 95% CI: 5.6–26.5%), and 47.4% in Syria (range: 21.0–75.0%; 95% CI: 32.5–62.5%). Genotypes 4 and 1 appear to be the dominant circulating strains. Conclusions HCV prevalence in the population at large appears to be below 1%, lower than that in other MENA sub-regions, and tending towards the lower end of the global range. However, there is evidence for ongoing HCV transmission within medical facilities and among people who inject drugs (PWID). Migration dynamics appear to have played a role in determining the circulating genotypes. HCV prevention efforts should be targeted, and focus on infection control in clinical settings and harm reduction among PWID.
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              Hepatitis C Virus Epidemiology in Djibouti, Somalia, Sudan, and Yemen: Systematic Review and Meta-Analysis

              Objectives To characterize hepatitis C virus (HCV) epidemiology and assess country-specific population-level HCV prevalence in four countries in the Middle East and North Africa (MENA) region: Djibouti, Somalia, Sudan, and Yemen. Methods Reports of HCV prevalence were systematically reviewed as per PRISMA guidelines. Pooled HCV prevalence estimates in different risk populations were conducted when the number of measures per risk category was at least five. Results We identified 101 prevalence estimates. Pooled HCV antibody prevalence in the general population in Somalia, Sudan and Yemen was 0.9% (95% confidence interval [95%CI]: 0.3%–1.9%), 1.0% (95%CI: 0.3%–1.9%) and 1.9% (95%CI: 1.4%–2.6%), respectively. The only general population study from Djibouti reported a prevalence of 0.3% (CI: 0.2%–0.4%) in blood donors. In high-risk populations (e.g., haemodialysis and haemophilia patients), pooled HCV prevalence was 17.3% (95%CI: 8.6%–28.2%) in Sudan. In Yemen, three studies of haemodialysis patients reported HCV prevalence between 40.0%-62.7%. In intermediate-risk populations (e.g.. healthcare workers, in patients and men who have sex with men), pooled HCV prevalence was 1.7% (95%CI: 0.0%–4.9%) in Somalia and 0.6% (95%CI: 0.4%–0.8%) in Sudan. Conclusion National HCV prevalence in Yemen appears to be higher than in Djibouti, Somalia, and Sudan as well as most other MENA countries; but otherwise prevalence levels in this subregion are comparable to global levels. The high HCV prevalence in patients who have undergone clinical care appears to reflect ongoing transmission in clinical settings. HCV prevalence in people who inject drugs remains unknown.
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                Author and article information

                Contributors
                kac2047@qatar-med.cornell.edu
                Journal
                J Evid Based Med
                J Evid Based Med
                10.1111/(ISSN)1756-5391
                JEBM
                Journal of Evidence-Based Medicine
                John Wiley and Sons Inc. (Hoboken )
                1756-5391
                24 May 2020
                August 2020
                : 13
                : 3 ( doiID: 10.1111/jebm.v13.3 )
                : 192-198
                Affiliations
                [ 1 ] Institute for Population Health, Weill Cornell Medicine Education City‐Qatar Foundation Doha Qatar
                Author notes
                [* ] Correspondence

                Karima Chaabna, Institute for Population Health, Weill Cornell Medicine‐Qatar, Education City‐Qatar Foundation, Doha, Qatar.

                Email: kac2047@ 123456qatar-med.cornell.edu

                Article
                JEBM12394
                10.1111/jebm.12394
                7497175
                © 2020 The Authors. Journal of Evidence‐Based Medicine published by Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 2, Tables: 1, Pages: 7, Words: 4715
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                Custom metadata
                2.0
                August 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.0 mode:remove_FC converted:11.09.2020

                Medicine

                gray literature, middle east, research design, systematic reviews, africa

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