TY - JOUR
T1 - Evidence-based interventions implemented in low-and middle-income countries for sickle cell disease management
T2 - A systematic review of randomized controlled trials
AU - Gyamfi, Joyce
AU - Ojo, Temitope
AU - Epou, Sabrina
AU - Diawara, Amy
AU - Dike, Lotanna
AU - Adenikinju, Deborah
AU - Enechukwu, Scholastica
AU - Vieira, Dorice
AU - Nnodu, Obiageli
AU - Ogedegbe, Gbenga
AU - Peprah, Emmanuel
N1 - Publisher Copyright:
Copyright: © 2021 Gyamfi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/2
Y1 - 2021/2
N2 - BACKGROUND: Despite ~90% of sickle cell disease (SCD) occurring in low-and middle-income countries (LMICs), the vast majority of people are not receiving evidence-based interventions (EBIs) to reduce SCD-related adverse outcomes and mortality, and data on implementation research outcomes (IROs) and SCD is limited. This study aims to synthesize available data on EBIs for SCD and assess IROs.METHODS: We conducted a systematic review of RCTs reporting on EBIs for SCD management implemented in LMICs. We identified articles from PubMed/Medline, Global Health, PubMed Central, Embase, Web of Science medical subject heading (MeSH and Emtree) and keywords, published from inception through February 23, 2020, and conducted an updated search through December 24, 2020. We provide intervention characteristics for each study, EBI impact on SCD, and evidence of reporting on IROs.MAIN RESULTS: 29 RCTs were analyzed. EBIs identified included disease modifying agents, supportive care agents/analgesics, anti-malarials, systemic treatments, patient/ provider education, and nutritional supplements. Studies using disease modifying agents, nutritional supplements, and anti-malarials reported improvements in pain crisis, hospitalization, children's growth and reduction in severity and prevalence of malaria. Two studies reported on the sustainability of supplementary arginine, citrulline, and daily chloroquine and hydroxyurea for SCD patients. Only 13 studies (44.8%) provided descriptions that captured at least three of the eight IROs. There was limited reporting of acceptability, feasibility, fidelity, cost and sustainability.CONCLUSION: EBIs are effective for SCD management in LMICs; however, measurement of IROs is scarce. Future research should focus on penetration of EBIs to inform evidence-based practice and sustainability in the context of LMICs.CLINICAL TRIAL REGISTRATION: This review is registered in PROSPERO #CRD42020167289.
AB - BACKGROUND: Despite ~90% of sickle cell disease (SCD) occurring in low-and middle-income countries (LMICs), the vast majority of people are not receiving evidence-based interventions (EBIs) to reduce SCD-related adverse outcomes and mortality, and data on implementation research outcomes (IROs) and SCD is limited. This study aims to synthesize available data on EBIs for SCD and assess IROs.METHODS: We conducted a systematic review of RCTs reporting on EBIs for SCD management implemented in LMICs. We identified articles from PubMed/Medline, Global Health, PubMed Central, Embase, Web of Science medical subject heading (MeSH and Emtree) and keywords, published from inception through February 23, 2020, and conducted an updated search through December 24, 2020. We provide intervention characteristics for each study, EBI impact on SCD, and evidence of reporting on IROs.MAIN RESULTS: 29 RCTs were analyzed. EBIs identified included disease modifying agents, supportive care agents/analgesics, anti-malarials, systemic treatments, patient/ provider education, and nutritional supplements. Studies using disease modifying agents, nutritional supplements, and anti-malarials reported improvements in pain crisis, hospitalization, children's growth and reduction in severity and prevalence of malaria. Two studies reported on the sustainability of supplementary arginine, citrulline, and daily chloroquine and hydroxyurea for SCD patients. Only 13 studies (44.8%) provided descriptions that captured at least three of the eight IROs. There was limited reporting of acceptability, feasibility, fidelity, cost and sustainability.CONCLUSION: EBIs are effective for SCD management in LMICs; however, measurement of IROs is scarce. Future research should focus on penetration of EBIs to inform evidence-based practice and sustainability in the context of LMICs.CLINICAL TRIAL REGISTRATION: This review is registered in PROSPERO #CRD42020167289.
KW - Anemia, Sickle Cell/pathology
KW - Antisickling Agents/therapeutic use
KW - Developing Countries
KW - Disease Management
KW - Evidence-Based Medicine/methods
KW - Hospitalization
KW - Humans
KW - Poverty
KW - Randomized Controlled Trials as Topic
KW - Reproducibility of Results
KW - Treatment Outcome
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U2 - 10.1371/journal.pone.0246700
DO - 10.1371/journal.pone.0246700
M3 - Review article
C2 - 33596221
AN - SCOPUS:85101404436
SN - 1932-6203
VL - 16
JO - PloS one
JF - PloS one
IS - 2
M1 - e0246700
ER -