It has been suggested that the COVID-19 pandemic led to an increase in self-medication practices across the world. Yet, there is no up-to-date synthesized evidence on the prevalence of self-medication that is attributable to the pandemic. This study aimed to conduct a systematic literature review on the prevalence and correlates of self-medication for the prevention and treatment of COVID-19 globally. The review was registered with the PROSPERO database. Searches were conducted following PRISMA guidelines, and relevant articles published between 1 April 2020 and 31 March 2022 were included. Pooled prevalence rate was conducted using the Meta package in R. A total of 14 studies from 14 countries, which represented 15,154 participants, were included. The prevalence of COVID-19-related self-medication ranged from 3.4–96%. The pooled prevalence of self-medication for this purpose was 44.9% (95% CI: 23.8%, 68.1%). Medications reported by studies for self-medication were antibiotics (79%), vitamins (64%), antimalarials (50%), herbal and natural products (50%), analgesics and antipyretics (43%), minerals and supplements (43%), cold and allergy preparations (29%), corticosteroids (14%), and antivirals (7%). The prevalence of self-medication with antibiotics is concerning. More public health education about responsible self-medication amidst the COVID-19 pandemic and future pandemics is required to mitigate the rising threat of antimicrobial resistance.
While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, expanding the grounds on which abortion can be performed legally. However, the implications of these reforms on women’s access to and use of health services, as well as their health outcomes, are uncertain. This systematic review aimed to evaluate and synthesize empirical research evidence concerning the effects of abortion law reforms on women’s health services and health outcomes in LMICs. We searched Medline, Embase, CINAHL and Web of Science databases, as well as grey literature and reference lists of included studies. We included pre–post and quasi-experimental studies that aimed to estimate the causal effect of a change in abortion law on at least one of four outcomes: (1) use of and access to abortion services, (2) fertility rates, (3) maternal and/or neonatal morbidity and mortality and (4) contraceptive use. We assessed the quality of studies using the quasi-experimental study design series checklist and synthesized evidence through a narrative description. Of the 2796 records identified by our search, we included 13 studies in the review, which covered reforms occurring in Uruguay, Ethiopia, Mexico, Nepal, Chile, Romania, India and Ghana. Studies employed pre–post, interrupted time series, difference-in-differences and synthetic control designs. Legislative reforms from highly restrictive to relatively liberal were associated with reductions in fertility, particularly among women from 20 to 34 years of age, as well as lower maternal mortality. Evidence regarding the impact of abortion reforms on other outcomes, as well as whether effects vary by socioeconomic status, is limited. Further research is required to strengthen the evidence base for informing abortion legislation in LMICs. This review explicitly points to the need for rigorous quasi-experimental studies with sensitivity analyses to assess underlying assumptions. The systematic review was registered in PROSPERO database CRD42019126927.
Objectives: We sought to determine how the Health Belief Model (HBM) constructs relate to Human Immunodeficiency Virus (HIV) screening decisions among international students and which of the HBM constructs was most relevant in those screening decisions. Methods: We conducted a cross-sectional pilot study using an online survey of international students at Western Illinois University in the United States. Participants signed electronic informed consent. The online survey comprised of questions that assessed their sociodemographic characteristics, acceptance of HIV screening, and perceived knowledge of HIV. The survey also determined the role of perceived benefits, perceived threat, and cues to action in making HIV screening decisions among the study population. Results: Four hundred and ninety students were invited to participate in the survey out of which 185 responses were obtained. In all, 107(57.8%) were males, and 78(42.8%) were females. Most of the respondents were from Asia (64.9%) and Africa (24.9%). The prevalence of acceptance of HIV screening among international students was found to be 73.5%. About 90% of the participants perceived HIV screening to be beneficial to their health, and 76% of them would accept the screening because they were offered. The majority (83%) of participants who said that they would not accept HIV screening, were also not sexually active, and they did not think they could be susceptible to HIV. Conclusion and Implications for Translation: Perceived benefits and cues to action were found to be the significant factors that informed the decision of people who accepted to be screened for HIV. Perceived susceptibility informed the decision of those that rejected the screening. Caution is warranted in generalizing the findings from this study because of the limited sample size; however, we are confident that our findings are reproducible in a larger population context. Key words: • HIV • HIV screening • Decision • Acceptance • Perceived benefit • Perceived threat • Perceived susceptibility • Health belief model • International students Copyright © 2020 Ayosanmi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The present systematic review sought to evaluate the effects of Sodium Lauryl Sulfate (SLS)‐free compared to SLS‐containing dentifrices on (Recurrent) aphthous stomatitis (RAS) in patients with this condition. Cochrane, Medline (PubMed) and Embase databases, and some trial registries were searched through December 2017. There was no language, nor publication year restrictions. We included double‐blinded randomized controlled trials that compared the effects of dentifrices with and without SLS on RAS in humans. Data extraction was compliant with PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. PROSPERO 2018:CRD42018086001. Four trials were included in this review (all crossover studies; n = 124 participants) and two contributed to the main meta‐analysis based on the random‐effect model. SLS‐free dentifrice, when compared to SLS‐containing statistically significantly, reduced the number of ulcers, duration of ulcer, number of episodes, and ulcer pain. Sensitivity analysis of the four studies as parallel‐group trials shows a consistent direction of effect in favor of SLS‐free dentifrice usage. In conclusion, the qualitative and quantitative synthesis of the eligible trials for this review showed that use of SLS‐free consistently reduced all four parameters of ulcers measured. The available evidence suggests that patients with RAS may benefit from using SLS‐free dentifrices for their daily oral care. However, future well‐designed trials are still required to strengthen the current body of evidence.
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