Epidemiology of multimorbidity among people living with HIV in sub-Saharan Africa: a systematic review protocol

Kelechi Elizabeth Oladimeji; Armstrong Dzomba; Olatunji Adetokunboh; Lindiwe Zungu; Sanni Yaya; Daniel Ter Goon

doi:10.1136/bmjopen-2020-036988

Epidemiology of multimorbidity among people living with HIV in sub-Saharan Africa: a systematic review protocol

BMJ Open. 2020 Dec 12;10(12):e036988. doi: 10.1136/bmjopen-2020-036988.

Authors

Kelechi Elizabeth Oladimeji^{1

2}, Armstrong Dzomba³, Olatunji Adetokunboh^{4

5}, Lindiwe Zungu², Sanni Yaya⁶, Daniel Ter Goon⁷

Affiliations

¹ Faculty of Health Sciences, University of Fort Hare, East London, South Africa oladimejikelechi@yahoo.com.
² College of Graduate Studies, University of South Africa, Johannesburg, South Africa.
³ Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁴ DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa.
⁵ Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
⁶ Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada.
⁷ Faculty of Health Sciences, University of Fort Hare, East London, South Africa.

Abstract

Introduction: Sub-Saharan Africa remains the epicentre of the HIV pandemic, yet enormous knowledge gaps still exist to elicit a comprehensive portrait of multimorbidity and HIV linkage. This study aims to conduct a systematic meta-analysis of peer-reviewed literature to investigate the current status of multimorbidity epidemiology among people living with HIV (PLHIV) in sub-Saharan Africa.

Methods and analysis: Our review will assess observational studies (ie, cohort, case-control and cross-sectional) on multimorbidity associated with HIV/AIDS between 1 January 2005 and 31 October 2020 from sub-Saharan Africa. Databases to be searched include PubMed/MEDLINE, Scopus, Web of Science, Cochrane library, African Index Medicus and African Journals Online. We will also search the WHO clinical trial registry and databases for systematic reviews. The search strategy will involve the use of medical subject headings and key terms to obtain studies on the phenomena of HIV and multimorbidity at high precision. Quality assessment of eligible studies will be ascertained using a validated quality assessment tool for observational studies and risk of bias through sensitivity analysis to identify publication bias. Further, data on characteristics of the study population, multimorbid conditions, epidemiological rates and spatial distribution of multimorbid conditions in PLHIV will be extracted. Heterogeneity of individual studies will be evaluated using the I² statistic from combined effect size estimates. The statistical analysis will be performed using STATA statistical software V.15 and results will be graphically represented on a forest plot.

Ethics and dissemination: Ethical approval is not applicable in this study as it is a systematic review of published literature. The review findings may also be presented at conferences or before other relevant stakeholders.

Prospero registration number: CRD42020148668.

Keywords: HIV & AIDS; epidemiology; public health.

MeSH terms

Africa South of the Sahara / epidemiology
Cross-Sectional Studies
HIV Infections* / epidemiology
Humans
Meta-Analysis as Topic
Multimorbidity*
Research Design
Systematic Reviews as Topic