Background Treatment seeking delay is defined as the time interval between the onset of the major symptoms of tuberculosis (TB) and the first visit to the formal health care facility. The patient was said to be delayed if the patient visited the health-facility after 3 weeks onset of major symptoms. However, in low-income countries like Ethiopia, the delay in treatment-seeking among tuberculosis patients contributes to a widespread transmission and high prevalence of tuberculosis. Methods Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. A funnel plot was used for visual assessment of publication bias. Subgroup analyses were performed to explore the possible causes of heterogeneity. Egger’s weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. STATA software version 14 was used for all statistical analyses. Result A total of 12 studies with 5122 total sample size were included. The national pooled prevalence of treatment seeking delay was 44.29% (95% CI: 39.805, 48.771). The visual inspection of the funnel plot showed the asymmetrical distribution, and the Egger test showed insignificant (P = 0.348). Patients who did not seek formal health care providers on a first contact had about 7 times more likely to delay than patients who sought formal health care provider on a first contact (OR: 7.192 ((95% CI 5.587–9.257), P = 0.001, I2: 85%). The others independent predictors of delay were rural residence (OR: 3.459 ((95% CI 1.469–8.148), P ≤ 0.001), extra pulmonary TB (OR: 2.520 ((95% CI 1.761–3.605), 0.180), lower educational level (OR 11.720 ((95% CI 1.006–2.938), P <0.001), and distance more than 10km from health facility (OR: 1.631 ((95% CI (10.858–3.101), P = 0.001). Conclusion In this review, we identified a substantial treatment seeking delay among TB patients in Ethiopia. And, the independent predictors of delay were treatment sought before formal health care provider, residence of the patient, type of TB, educational level, and distance from a health facility. Thus, we recommend health extension workers, health professionals and other stakeholders to focus on patient education, and to continuously mobilize the whole communities on early treatment seeking with a special emphasis given to where treatment sought before formal health care provider, rural resident, extra pulmonary TB, and a patient living farther than 10km distance from health facility.
Background Postoperative sore throat is a common, uncomfortable, stressful sequel of tracheal intubation that contributes to postoperative mortality and morbidity following general anesthesia. Therefore, reducing risks of post-operative sore throat is important to improve patient outcome. Objectives The objective of this systematic review and meta-analysis was to evaluate the incidence and risk factors of postoperative sore throat among patients who underwent surgery. Methods Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, Hinari and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. Funnel plot was used for visual assessment of publication bias. Subgroup analyses by country and meta-regression was performed to explore the possible causes of heterogeneity. Egger’s weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. Stata v14.0 (Statacorp, College Station, Texas, USA) software was used for all statistical analyses. STATA software version 14 was used for all statistical analyses. Result A total of 11 studies with 5885 total sample size were included. The total number of patients who developed Post-operative sore throat was 2252. The pooled prevalence of Post-operative sore throat was 40.48% (95% CI: 35.16, 45.79). The visual inspection of the funnel plot showed the symmetrical distribution. Patients who had number of a single attempts were about 42.5% less likely to develop POST than patients who had multiple intubation attempts (OR: 0.58(0.38–0.88), P = 010, I2: 86.6%. Additionally, duration of tube in place less than 1 h was about 18.7% more likely to develop POST than who were not (OR: 1.19(0.29–4.79), P = 0.028, I2: 0.0%). The other independent predictors of POST were OR: 3.01(0.57–15.84), P = 0.19, I2: 92.3%) and OR: 1.56(0.97–2.58), P = 0.080, I2: 0.0%) respectively. Conclusions Patients’ age and sex, size of ETT and LMA, duration of ETT in trachea, experience of anesthetists’, number of attempts, induction agent, and smoking were revealed more common causes of sore throat. The number of attempts and the length of tube in place were both linked to the occurrence of postoperative sore throat. Research Registry Our unique identifying number is reviewregistry1416. Highlights
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