Background: Prognostic factors for the Coronavirus disease 2019 (COVID1-9) are not well established. This study aimed to summarize the available data on the association between the severity of COVID-19 and common hematological, inflammatory and biochemical parameters. Methods: EMBASE, MEDLINE, Web of sciences were searched to identify all published studies providing relevant data. Random-effects meta-analysis was used to pool effect sizes. Results: The bibliographic search yielded 287 citations, 31 of which were finally retained. Meta-analysis of standardized mean difference (SMD) between severe and non-severe COVID-19 cases showed that CK-MB (SMD = 0.

Background Although diabetes and poor glycaemic control significantly increase the risk of tuberculosis and adversely affect tuberculosis treatment outcomes, the global burden of diabetes in the context of tuberculosis remains unknown. We did a systematic review and meta-analysis to estimate the prevalence of diabetes among patients with tuberculosis at global, regional, and country levels. MethodsWe searched PubMed, Excerpta Medica Database, Web of Science, and Global Index Medicus to identify studies published between Jan 1, 1986, and June 15, 2017, on the prevalence of diabetes in patients with active tuberculosis, with no language restrictions. Criteria to diagnose tuberculosis and diabetes concurred with WHO guidelines. Methodological quality of eligible studies was assessed, and random-effect models meta-analysis served to obtain the pooled prevalence estimate of diabetes among patients with active tuberculosis, globally. Heterogeneity (I²) was assessed via the χ² test on Cochran's Q statistic. This study is registered with PROSPERO, number CRD42016049901. FindingsWe screened 7565 records of which 200 studies (2 291 571 people with active tuberculosis) were included in meta-analyses. The pooled prevalence of diabetes was 15·3% (95% prediction interval 2·5-36·1; I² 99·8%), varying from 0·1% in Latvia to 45·2% in Marshall Islands. Subgroup and metaregression analyses for identifying sources of heterogeneity showed that four International Diabetes Federation (IDF) regions (North America and Caribbean [19·7%], western Pacific [19·4%], southeast Asia [19·0%], Middle East and North Africa [17·5%]) had significantly higher prevalence estimates than the three others (Africa [8·0%], South and Central America [7·7%], and Europe [7·5%]; p<0·0001). Additionally, the prevalence increased with age, in men, and in countries with low tuberculosis burden. The prevalence of diabetes was decreased in countries that had low incomes and low Human Development Index scores. The form of tuberculosis infection and presence of HIV seemed not to affect the prevalence of diabetes among patients with active tuberculosis.Interpretation This study suggests a high burden of diabetes among patients with active tuberculosis, with disparities according to age, sex, regions, level of country income, and development. Cost-effective strategies to curb the burden of diabetes among patients with active tuberculosis are needed.

Currently, the coronavirus disease 2019 (COVID-19) is the priority of the global health agenda. Since the first case was reported in Wuhan, China, this infection has continued to spread and has been considered as a pandemic by the World Health Organization (WHO) within 3 months of its outbreak. Several studies have been done to better understand the pathogenesis and clinical aspects of the disease. It appears that COVID-19 affects almost all body organs due to the direct effect of the virus and its induced widespread inflammatory response. This multi-systemic aspect of the disease has to be inculcated in COVID-19 management by health providers to improve patient outcomes. This strategy could help curb the burden of the disease especially in low-and middle-income countries (LMICs) like most African countries where the pandemic is at an "embryonic" stage.

Background: Although HIV infection and antiretroviral therapy (ART) increase the risk for hypertension in people living with HIV (PLHIV), the global and regional burden of hypertension in PLHIV is not well characterized. Methods: In this systematic review and meta-analysis, we searched multiple databases for studies reporting on hypertension in PLHIV and conducted between 2007 and 2018. Meta-analysis through random-effect models served to obtain the pooled prevalence estimates. Heterogeneity was assessed via the χ2 test on Cochran's Q statistic. Results: We included 194 studies (396 776 PLHIV from 61 countries). The global prevalence of hypertension was 23.6% [95% confidence interval (95% CI: 21.6–25.5)] with substantial heterogeneity. The regional distribution was Western and Central Europe and North America [28.1% (95% CI: 24.5–31.9)], West and Central Africa [23.5% (16.6–31.0)], Latin America and the Caribbean [22.0% (17.8–26.5)], Eastern and Southern Africa [19.9% (17.2–22.8)], and Asia and Pacific [16.5% (12.5–21.0)]; P = 0.0007. No study originated from the Middle East and North Africa, and Eastern Europe and Central Asia regions. The prevalence was higher in high-income countries than others (P = 0.0003) and higher in PLHIV taking ART than those ART-naive (P = 0.0003). The prevalence increased over time (mainly driven by Eastern and Southern Africa) and with age. There was no difference between men and women. We estimated that in 2018, there were 8.9 (95% CI: 8.3–9.6) million cases of hypertension in PLHIV globally, among whom 59.2% were living in Sub-Saharan Africa. Conclusion: Cost-effective strategies to curb the dreadful burden of hypertension among PLHIV are needed.

ObjectivesThis scoping review sought to summarise available data on the prevalence, aetiology, diagnosis, treatment and outcome of pericardial disease in Africa.MethodsWe searched PubMed, Scopus and African Journals Online from 1 January 1967 to 30 July 2017 to identify all studies published on the prevalence, aetiologies, diagnosis, treatment and outcomes of pericardial diseases in adults residing in Africa.Results36 studies were included. The prevalence of pericardial diseases varies widely according to the population of interest: about 1.1% among people with cardiac complaints, between 3.3% and 6.8% among two large cohorts of patients with heart failure and up to 46.5% in an HIV-infected population with cardiac symptoms. Tuberculosis is the most frequent cause of pericardial diseases in both HIV-uninfected and HIV-infected populations. Patients with tuberculous pericarditis present mostly with effusive pericarditis (79.5%), effusive constrictive pericarditis (15.1%) and myopericarditis (13%); a large proportion of them (up to 20%) present in cardiac tamponade. The aetiological diagnosis of pericardial diseases is challenging in African resource-limited settings, especially for tuberculous pericarditis for which the diagnosis is not definite in many cases. The outcome of these diseases remains poor, with mortality rates between 18% and 25% despite seemingly appropriate treatment approaches. Mortality is highest among patients with tuberculous pericarditis especially those coinfected with HIV.ConclusionPericardial diseases are a significant cause of morbidity and mortality in Africa, especially in HIV-infected individuals. Tuberculosis is the most frequent cause of pericardial diseases, and it is associated with poor outcomes.

BackgroundThe epidemiology of infective endocarditis in Africa is inadequately characterised. We therefore aimed to comprehensively summarise the available data for the incidence, risk factors, clinical pattern, microbiology, and outcomes of infective endocarditis in Africa. MethodsWe did a systematic review and meta-analysis. We searched PubMed, Embase, African Index Medicus, and African Journals Online for all studies reporting primary data for the epidemiology of infective endocarditis in populations within Africa, published from inception to Jan 14, 2021, irrespective of the language. We used the search terms "endocarditis", "Africa", and the name of all African countries in the search strategy. We excluded articles that did not include primary data, primary studies with a small sample size (<30 participants), and those that report findings from before 1990. We recorded data for study characteristics, sample size, criteria used to define infective endocarditis, risk factors, potential entry site, clinical patterns, microbiology profile, outcomes including complications such as embolic events, heart failure, acute kidney injury, and death, and predictors of death. We used random-effects meta-analysis method to pool estimates. This study is registered with PROSPERO, CRD42021243842. FindingsWe retrieved 2141 records from the database and bibliographic searches, of which a total of 42 studies were included in this systematic review. Rheumatic heart disease was the most common risk factor for infective endocarditis in adults (52•0% [95% CI 42•4-61•5]), whereas congenital heart disease was the most common risk factor for infective endocarditis in children (44•7% [29•5-60•5]). Microbiological testing (mostly blood cultures) was positive in 48•6% (95% CI 42•2-51•1) of patients with infective endocarditis, with Staphylococcus species (41•3% [95% CI 36•2-46•5]) and Streptococcus species (34•0% [29•0-39•3]) the most commonly identified microorganisms. The pooled rate of surgical treatment of infective endocarditis was 49•1% (95% CI 43•2-55•1). The pooled in-hospital mortality rate was 22•6% (95% CI 19•5-25•9). Other frequent complications included heart failure (47•0% [95% CI 38•2-56•0]), acute kidney injury (22•8% [18•8-27•0]), and embolic events (31•1% [22•2-40•7]). Interpretation As the most prevalent risk factor in Africa, rheumatic heart disease should be central in interventions to reduce the burden of infective endocarditis on the continent. In tertiary hospitals with good access to cardiac surgery, the outcomes of infective endocarditis seem relatively similar to what has been reported in other parts of the world, especially in high-income countries.

No abstract

Data on masked hypertension (MH) and white-coat hypertension (WCH) in African populations are needed to estimate the true prevalence of hypertension in these populations because they have the highest burden of the disease. We conducted the first systematic review and meta-analysis that summarized available data on the prevalence of WCH and MH in Africa. We searched PubMed and Scopus to identify all the articles published on MH and WCH in populations living in Africa from inception to November 30, 2017. We reviewed each study for methodological quality. A random-effects model was used to estimate the prevalence of WCH and MH across studies. Eleven studies were included, all having a low-risk of bias. The prevalence of masked hypertension was 11% (95% CI: 4.7-19.3; 10 studies) in a pooled sample of 7789 individuals. The prevalence of WCH was 14.8% (95% CI: 9.4-21.1; 8 studies) in a pooled sample of 4451 individuals. There was no difference on the prevalence of WCH and MH between studies in which participants were recruited from the community and the hospital. The prevalence of MH was higher in urban areas compared to rural ones; there was no difference for WCH. WHC and MH seem to be frequent in African populations, suggesting the importance of out-of-clinic BP measurement in the diagnosis and management of patients with hypertension in Africa, especially in urban areas for MH.