Gelaw Yared Mulu, Guracho Yonas Deressa, Robert-Gangneux Florence, Alene Getu Degu, Gangneux Jean-Pierre
Department of Health Service and Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar H9FX+Q62, Ethiopia.
Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Univ Rennes, CHU Rennes, Inserm, EHESP, F-35000 Rennes, France.
Trop Med Infect Dis. 2023 Feb 13;8(2):114. doi: 10.3390/tropicalmed8020114.
pneumonia (PCP) is a leading cause of death among patients with AIDS worldwide, but its burden is difficult to estimate in low- and middle-income countries, including Ethiopia. This systematic review aimed to estimate the pooled prevalence of PCP in Ethiopia, the second most densely populated African country. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to review published and unpublished studies conducted in Ethiopia. Studies that reported on the prevalence of PCP among HIV-infected patients were searched systematically. Variations between the studies were assessed by using forest plot and I-squared heterogeneity tests. Subgroup and sensitivity analyses were carried out when I2 > 50. The pooled estimate prevalence with 95% CI was computed using a random-effects model of analysis. Thirteen articles, comprising studies of 4847 individuals living with HIV, were included for analysis. The pooled prevalence of PCP was 5.65% (95% CI [3.74-7.56]) with high heterogeneity (I2 = 93.6%, < 0.01). To identify the source of heterogeneity, subgroup analyses were conducted by study design, geographical region, diagnosis methods, and year of publication. PCP prevalence differed significantly when biological diagnostic methods were used (32.25%), in studies published before 2010 (32.51%), in cross-sectional studies (8.08%), and in Addis Ababa (14.05%). PCP prevalence differences of 3.25%, 3.07%, 3.23%, and 2.29% were recorded in studies based on clinical records, published since 2017, follow-up studies, and north-west Ethiopian studies, respectively. The prevalence of PCP is probably underestimated, as the reports were mainly based on clinical records. An expansion of biological diagnostic methods could make it possible to estimate the exact burden of PCP in Ethiopia.
肺炎（肺孢子菌肺炎，PCP）是全球艾滋病患者的主要死因之一，但在包括埃塞俄比亚在内的低收入和中等收入国家，其负担难以估计。本系统评价旨在估计在非洲人口第二密集的国家埃塞俄比亚PCP的合并患病率。采用系统评价与Meta分析的首选报告项目（PRISMA）指南对埃塞俄比亚已发表和未发表的研究进行综述。系统检索报告HIV感染患者中PCP患病率的研究。采用森林图和I²异质性检验评估研究之间的差异。当I²>50时进行亚组分析和敏感性分析。使用随机效应分析模型计算合并估计患病率及95%置信区间。纳入13篇文章进行分析，这些文章包含对4847名HIV感染者的研究。PCP的合并患病率为5.65%（95%置信区间[3.74 - 7.56]），异质性较高（I² = 93.6%，P<0.01）。为确定异质性来源，按研究设计、地理区域、诊断方法和发表年份进行亚组分析。使用生物学诊断方法时PCP患病率差异显著（32.25%），2010年前发表的研究中（32.51%）、横断面研究中（8.08%）以及亚的斯亚贝巴（14.05%）的患病率也有显著差异。基于临床记录的研究、2017年以来发表的研究、随访研究以及埃塞俄比亚西北部的研究中PCP患病率差异分别为3.25%、3.07%、3.23%和2.29%。由于报告主要基于临床记录，PCP的患病率可能被低估。扩大生物学诊断方法的应用可能有助于准确估计埃塞俄比亚PCP的负担。
