BackgroundMedical and socio-economic uncertainties surrounding the COVID-19 pandemic have had a substantial impact on mental health. This study aimed to systematically review the existing literature reporting the prevalence of anxiety and depression among the general populace in Africa during the COVID-19 pandemic and examine associated risk factors.MethodsA systematic search of the following databases African Journal Online, CINAHL, PubMed, Scopus, and Web of Science was conducted from database inception until 30th September 2021. Studies reporting the prevalence of anxiety and/or depression among the general populace in African settings were considered for inclusion. The methodological quality of included studies was assessed using the Agency for Healthcare Research and Quality (AHRQ). Meta-analyses on prevalence rates were conducted using Comprehensive Meta-analysis software.ResultsSeventy-eight primary studies (62,380 participants) were identified from 2,325 studies via electronic and manual searches. Pooled prevalence rates for anxiety (47%, 95% CI: 40–54%, I2 = 99.19%) and depression (48%, 95% CI: 39–57%, I2 = 99.45%) were reported across Africa during the COVID-19 pandemic. Sex (female) and history of existing medical/chronic conditions were identified as major risk factors for anxiety and depression.ConclusionsThe evidence put forth in this synthesis demonstrates the substantial impact of the pandemic on the pervasiveness of these psychological symptoms among the general population. Governments and stakeholders across continental Africa should therefore prioritize the allocation of available resources to institute educational programs and other intervention strategies for preventing and ameliorating universal distress and promoting psychological wellbeing.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021228023, PROSPERO CRD42021228023.
Objective: To determine the effects of nonsurgical, minimally or noninvasive therapies on urge urinary incontinence (UUI) symptoms and quality of life (QoL) in individuals with neurogenic bladder (NGB). Data Sources: Cochrane library, EMBASE, MEDLINE, PEDro, Scopus, and Web of Science databases were searched from inception to September 2021. Review Methods: Randomized controlled trials that compared therapies such as intravaginal electrical stimulation (IVES), transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), transcutaneous tibial nerve stimulation (TTNS), pelvic floor muscle training (PFMT), and behavioural therapy (BT) to control were included. Study screening, data extraction, and study quality assessments were performed by two independent authors. Results: Fourteen trials with 804 participants were included in the study after screening of 4281 potentially relevant articles. Meta-analyses revealed a significant effect of electrical stimulation on UUI due to multiple sclerosis (standardized mean difference (SMD): −0.614; 95% confidence interval (CI): −1.023, −0.206; p = 0.003) and stroke (SMD: −2.639; 95% CI: −3.804, −1.474; p = 0.000). The pooled analyses of TTNS (weighted mean difference (WMD): −12.406; 95% CI: −16.015, −8.797; p = 0.000) and BT (WMD: −9.117; 95% CI: −14.746, −3.487; p = 0.002) revealed significant effects of these interventions on QoL in people with Parkinson’s disease. However, meta-analyses revealed nonsignificant effects for PFMT (WMD: −0.751; 95% CI: −2.426, 0.924; p = 0.380) and BT (WMD: −0.597; 95% CI: −1.278, 0.083; p = 0.085) on UUI due to Parkinson’s disease. Conclusions: Our meta-analyses found electrical stimulation to be beneficial for improving the symptoms of UUI among people with multiple sclerosis and those with stroke. Our review also revealed that TTNS and BT might improve QoL for people with NGB due to Parkinson’s disease, although the effects of PFMT and BT on UUI warrant further investigation.
Background Botulinum toxin-A (BoNT) reduce over-firing of dystonic muscles, spasmodic contractions by enhancing function. We conducted a systematic review and random-effects meta-regression to investigate the efficacy and safety of BoNT in writer’s cramp (WC). Published electronic articles from inception till January 2022 were screened from four databases (Medline, Science Direct, Scopus, ProQuest). Effect sizes in the form of standardized mean differences were calculated for estimation of efficacy. Results Nineteen studies [six randomized control trials (RCTs) and 13 observational studies] involved 587 (514 experimental; 73 Controls) participants with mean age of 43.46 ± 8.84 years with mean duration of WC of 8.31 ± 5.35 years. Injection did not result in significant improvement in writing speed [standard mean difference (95% CI) 0.06 (− 0.35, 0.46)]. There was no significant difference in writing speed as compared to controls [standard mean difference (95% CI) − 0.51 (− 2.55, 1.52)]. The meta-analysis of observational studies showed a significant difference in the mean WC rating score [standard mean difference (95% CI) 0.54 (0.20, 0.88)]. Pooled analysis (observational studies and RCTs) demonstrated a significant difference in the mean Writer’s cramp rating score (WCRS) after BoNT [standard mean difference (95% CI) 0.75 (0.06, 1.44)]. No major safety concerns were reported in the included studies. Conclusions According to the meta-analysis of observational studies, BoNT injections are effective in WC for improving WCRS without major safety concerns. However, according to the meta-analysis of RCTs, there was no significant effect in efficacy with BoNT.
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