Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
BMC Infect Dis. 2020 Mar 12;20(1):214. doi: 10.1186/s12879-020-4935-x.
In Ethiopia, by the end of 2018, an estimated 690,000 people are infected with HIV and the annual cases of Visceral Leishmaniasis (VL) is estimated to be between 4000 and 5000 with over 3.2 million people are at risk. Northwest Ethiopia accounts for over 60% cases of VL in the country. Prevalence of HIV infection among VL infected people in Ethiopia has not yet been synthesized. Therefore, we aimed to estimate the pooled prevalence of HIV infection among VL infected people in Northwest Ethiopia with the hope that it would guide the development of a more robust and cost-effective intervention strategies.
In this systematic review and meta-analysis, we searched six international databases: PubMed, Ovid MEDLINE®, Embase, Scopus, Google Scholar, and ProQuest Dissertations & Theses. We also searched reference lists of included studies and Ethiopian universities electronic thesis and dissertation repositories. The search was performed until June 30,2019. Funnel plot symmetry visualization confirmed by Egger's regression asymmetry test and Begg rank correlation methods was used to assess publication bias. Pooled prevalence estimate was calculated using Der Simonian and Laird's random Effects model. We went further to perform univariate meta-regression and subgroup analysis to identify a possible sources of heterogeneity among the studies. STATA software (version 14, Texas, USA) was used for analysis.
From 1286 citations identified by our search, 19 relevant studies with 5355 VL infected individuals were included in this meta-analysis. The pooled prevalence of HIV infection among VL infected individuals in Northwest Ethiopia was 24% (95%CI: 17-30%). The result of sensitivity analysis demonstrated that the pooled prevalence estimate was robust and not one-study dependent. The pooled prevalence estimate of HIV infection among VL infected people in Northwest Ethiopia ranged from 20.88% (95%CI: 15.91-25.86) to 24.86% (95%CI: 18.57-31.14) after a single study was deleted.
The burden of HIV infection in people infected with VL in Northwest Ethiopia is considerably high. Integrating HIV/AIDS surveillance among VL infected people would improve case detection as well as prevention and control of disease spread.
在埃塞俄比亚，截至 2018 年底，估计有 69 万人感染艾滋病毒，每年内脏利什曼病（VL）的病例数估计在 4000 至 5000 例之间，有超过 320 万人面临感染风险。埃塞俄比亚西北部占该国 VL 病例的 60%以上。艾滋病毒感染在埃塞俄比亚 VL 感染者中的流行率尚未综合。因此，我们旨在估计埃塞俄比亚西北部 VL 感染者中艾滋病毒感染的合并患病率，希望这能指导制定更强大和更具成本效益的干预策略。
在这项系统评价和荟萃分析中，我们搜索了六个国际数据库：PubMed、Ovid MEDLINE®、Embase、Scopus、Google Scholar 和 ProQuest Dissertations & Theses。我们还搜索了纳入研究的参考文献列表和埃塞俄比亚大学电子论文和论文存储库。搜索一直持续到 2019 年 6 月 30 日。使用 Egger 回归不对称检验和 Begg 等级相关方法的漏斗图对称性可视化来评估发表偏倚。使用 Der Simonian 和 Laird 的随机效应模型计算合并患病率估计值。我们进一步进行单变量荟萃回归和亚组分析，以确定研究之间可能存在的异质性来源。使用 STATA 软件（版本 14，德克萨斯州，美国）进行分析。
从我们的搜索中确定的 1286 条引文，有 19 项相关研究纳入了这项荟萃分析，涉及 5355 名 VL 感染者。埃塞俄比亚西北部 VL 感染者中艾滋病毒感染的合并患病率为 24%（95%CI：17-30%）。敏感性分析的结果表明，合并患病率估计值是稳健的，不受单一研究的影响。在删除一项研究后，埃塞俄比亚西北部 VL 感染者中 HIV 感染的合并患病率估计值范围为 20.88%（95%CI：15.91-25.86）至 24.86%（95%CI：18.57-31.14）。
艾滋病毒感染在埃塞俄比亚西北部 VL 感染者中的负担相当高。在 VL 感染者中整合艾滋病毒/艾滋病监测将提高病例发现率，并有助于预防和控制疾病传播。
