Digital Commons Network^™

Associations Between B Vitamin Interactions With Polyunsaturated Fatty Acids And Cognitive Function Among Cognitively Healthy Older People As Modified By Amyloid Status And Sex, Chuliang Zhao, Karen A. Abbott, Chinedu Momoh, Geraint Price, Oliver J. K. Robinson, Sujin Kang, Celeste A. De Jager Loots

Brain and Mind Institute

Background/Objectives: Nutrients such as vitamin B12, folate (B9), and polyunsaturated fatty acids (PUFAs) may independently influence cognitive health, but their combined effects and interactions remain unclear. This study aims to investigate the effects of B12, folate, and PUFAs, including their interactions, on cognitive function in cognitively healthy older adults, considering effect modification by sex and amyloid-beta status.

Methods: A cross-sectional analysis was conducted using data from 321 participants aged 60–85 y enrolled in the UK CHARIOT–PRO SubStudy. Dietary intake was assessed using the Scottish Collaborative Group Food Frequency Questionnaire, and cognitive performance was measured via the Repeatable Battery …

Experiences And Attitudes Of Caregivers During Mealtimes In Children With Autism Spectrum Disorder At A Tertiary Facility In Kenya., Lynnette Muthoni Mwangi

Master of Medicine in Paediatrics and Child Health

Introduction: - ASD is a neurodevelopmental disorder characterized by deficits in social interactions and communication along with restrictive and repetitive behaviours affecting 1 in 100 children globally, with a higher prevalence in males. Despite the rising global statistics, there is limited information regarding the prevalence of ASD in Sub-Saharan Africa. Children with ASD often experience feeding challenges, which have been broadly categorized as food selectivity, food refusal, and disruptive mealtime behaviour, which poses challenges for caregivers during mealtime. While medical management of ASD receives considerable attention, less focus has been placed on the impact of ASD on caregivers and …

Community Perspectives On Maternal Dietary Diversity In Rural Kenya, Mozambique And The Gambia: A Precise Network Qualitative Study, Mai-Lei Woo Kinshella, Shilla Dama, Onesmus Wanje, Rosa Pires, Helena Boene, Papa Jagne, Hawanatu Jah, Angela Koech, Grace Mwashigadi, Violet Naanyu

Centre of Excellence in Women and Child Health

Pregnant and lactating women in sub-Saharan Africa are vulnerable to micronutrient inadequacies, with risk of adverse pregnancy outcomes. Adequate intakes of diverse foods are associated with better micronutrient status and recommended by the World Health Organization as part of healthy eating counselling during antenatal care. However, our understanding of community knowledge of dietary diversity within the context of maternal diets is limited. We used a descriptive qualitative approach to explore community perceptions of dietary diversity during pregnancy and lactation, as well as influencing factors in sub-Saharan Africa. A total of 47 in-depth interviews were conducted between May and October 2022 …

Strengthening The Paediatric Clinical Trial Ecosystem To Better Inform Policy And Programmes, James A. Berkley, Judd L. Walson, Glenda Gray, Fiona Russell, Zulfiqar Ahmed Bhutta, Per Ashorn, Shane A. Norris, Ebunoluwa A. Adejuyigbe, Rebecca Grais, Bernhards Ogutu

Institute for Global Health and Development

The first WHO Global Clinical Trials Forum was convened in November, 2023 to develop a shared vision of an effective global clinical trial infrastructure. The Paediatric Clinical Trials Working Group was formed to provide perspectives, identify challenges, and propose solutions to strengthen the paediatric clinical trials ecosystem. Participants represented paediatric disciplines, including infectious diseases, nutrition, neonatology, pharmacology, oncology, neurodevelopment, public health, and policy. Childhood diseases have profound lifelong effects on health, livelihoods, and societies. Investment in early childhood results in highly cost-effective changes to lifelong health, productivity, and human capital returns. Yet, there remain substantial gaps in knowledge on the …

Institute For Global Health And Development : Issue 10 - April 2025, Institute For Global Health And Development

IGHD Newsletters

• Challenges and Opportunities for Poliovirus Eradication in Pakistan
• IGHD Participates in Workshop on Societal Impacts of Extreme Heat
• IGHD Participates in Roundtable in Pakistan’s Climate Prosperity Plan (CPP)
• Dr. Zulfiqar Bhutta Receives International Pediatric Association Lifetime Achievement Award
• Pakistan Urged to Make Bold Nutrition Pledges at N4G Summit 2025
• Dr. Jai Das Speaks at AKDN Webinar on Climate Change and Community Health

From Past To Present: Tracing Africa’S Path To Universal Health Coverage, Evaline Chepchirchir Langat, Paul Russell Ward, Hailay Abrha Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

At the 58th World Health Assembly in 2005, the international community charted a course for universal health coverage (UHC), aiming to ensure access to health care for all in need, of sufficient quality, and without causing financial hardship. At the time, barriers to accessing health care were overwhelming, particularly in low-and middle-income countries like Africa. Currently, 50 of Africa’s 54 countries are in various phases of UHC implementation. Some are developing national UHC agendas, while others have made significant progress but still face gaps in meeting UHC targets. This mini review comprehensively examines the literature to understand the temporal and …

Evaluating The Effect Of Consumption Of Fermented Foods On Glycemic Control And Markers Of Cardiometabolic Risk Amongst Pre-Diabetic And Type 2 Diabetes Mellitus Adult Patients: A Systematic Review And Meta-Analysis, Alex Makau Muia

Master of Medicine in Family Medicine

Introduction 

Type 2 diabetes mellitus (T2DM) remains a major global health challenge, particularly in resource limited countries where conventional treatments are often inaccessible or unaffordable. While lifestyle interventions can reduce diabetes risk, their efficacy is moderate, highlighting the need for alternative strategies. Fermented foods (FFs), which are widely available and affordable, have been shown to improve glucose metabolism and may offer a promising adjunct in the prevention and management of T2DM and prediabetes.

Methods 

A systematic review and meta-analysis were conducted to assess the effects of fermented food consumption on glycemic control and cardiometabolic risk markers in adults with prediabetes …

Neurocognitive Gains Among Ugandan Children With Sickle Cell Anemia On Hydroxyurea: 18-Month Trial Interim Results, Shubaya Kasule Naggayi, Dennis Kalibbala, Vincent Mboizi, John M. Ssenkusu, Zhezhen Jin, Caterina Rosano, Deogratias Munube, Bill Wambaka, Ruth Namazzi, Robert Opoka

Paediatrics and Child Health, East Africa

Children with sickle cell anemia (SCA) frequently develop progressive neurocognitive impairment. We aimed to determine effects of hydroxyurea therapy on neurocognitive function in Ugandan children with SCA by comparing levels at enrollment to a planned 18-month interim assessment. Ugandan children (N=264) ages 3-9 years were enrolled from a SCA clinic and treated in a 30-month singlearm open-label trial with escalation to maximum tolerated dose (MTD). Primary outcome was the effects of hydroxyurea on cognition, attention and executive function, along with transcranial doppler ultrasound (TCD) blood flow velocity. Sibling controls (N=110) without SCA underwent neurocognitive testing in parallel to establish age-normalized …

Correlation Between Fetal Abdominal Wall Adiposity And Neonatal Outcomes, Elaine Murugi Nyaga

Master of Medicine in Obstetrics and Gynecology

BACKGROUND 

Fetal growth is a result of complex interactions between genetic, nutritional, environmental, uteroplacental, and fetal factors which impact on delivery and subsequent neonatal outcomes. Fetal abdominal adiposity serves as an important indicator of fetal growth and body composition. While gestational diabetes mellitus (GDM) can influence fetal fat deposition, understanding how adiposity correlates with birth weight and neonatal outcomes in both GDM and non-GDM pregnancies provides insight into the broader significance of fetal adiposity as a marker of fetal health.

Methodology 

A cross-sectional study was conducted on 269 pregnant women to examine fetal abdominal adiposity, measured as fetal abdominal subcutaneous …

The Clinical Phenotype Of Motor Neurone Disease In A Kenyan Hospital – Based Population, Effie Nailah Kamadi

Master of Medicine in Internal Medicine

Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.

Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed at AKUHN between …

The Prevalence And The Predictors Of Diabetes Distress In Patients With Type 2 Diabetes Attending Diabetes Clinics At A Tertiary Private Hospital In Nairobi, Kenya., Soulthy Azamkhan Mohamed

Master of Medicine in Family Medicine

Background Diabetes distress encompasses a spectrum of emotional and psychological challenges faced by individuals managing diabetes, including anxiety, stress, depression, frustration, and feelings of helplessness. This distress arises from the constant demands of monitoring blood sugar levels, managing medications, adhering to dietary restrictions, engaging in regular physical activity, and navigating potential complications. Social and emotional factors such as stigma, discrimination, and concerns about future health further contribute to this burden. Factors like fear of hypoglycemia, financial strain, fluctuating blood sugar levels, anxiety about complications, and impacts on personal relationships exacerbate diabetes distress. Left unaddressed, diabetes distress can lead to poor …

Dementia In A Resource-Constrained Sub-Saharan African Setting: A Comprehensive Retrospective Analysis Of Prevalence, Risk Factors, And Management At The Only Neuropsychiatric Facility In Northeastern Nigeria, Ibrahim Abdu Wakawa, Umar Baba Musami, Suleiman Hamidu Kwairanga, Placidus Nwankuba Ogualili, Mohammed Yusuf Mahmood, Muhammad Abba Fugu, Mohammed Mala Gimba, Muktar Mohammed Allamin, Zaharadeen Umar Abbas, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION: Dementia prevalence is increasing in sub-Saharan Africa, poten-tially due to population growth and aging. Resource-constrained settings such asNortheastern Nigeria face challenges in dementia management.

METHODS: We assessed dementia burden and management at the Federal Neuropsy-chiatric Hospital Maiduguri, the only neuropsychiatric facility in Northeastern Nigeria.This retrospective analysis included patient records from 1999 to 2023 for individuals60 year of age and older with a dementia diagnosis.

RESULTS: Of the 1216 cases reported, Alzheimer’s disease (60.5%) was the mostcommon subtype, followed by vascular dementia (24.5%). Hypertension (41.6%) wasthe most frequent comorbidity. Memory loss was present in all cases, whereasbehavioral …

Annual Report 2024 Oah, Office Of Allied Health

Office of Allied Health (OAH) Archives

• Dean’s Message
• A Year of Progress, A Future of Possibilities
• Advancing Initiatives for Allied Health Faculty Development:
• Academic Development
• Student Initiative
• Research Development
• Collaboration and Networking
• Elevating the Profile of Allied Health Professions
• Allied Health Events by Departments

Neonatal Care In Low- And Middle-Income Countries: A Fresh Look, Ola D. Saugstad, Joy E. Lawn, Peter Waiswa, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

No abstract provided.

Spectrum Of Venous Thromboembolism In Adult Patients With Ulcerative Colitis In Pakistan: A Single Center Retrospective Study, Masood Muhammad Karim, , Hafsa Shaikh, Faisal Wasim Ismail

Department of Medicine

Background: Patients with inflammatory bowel disease are at a 2-8-fold higher risk of developing venous thromboembolism (VTE) as compared to the general population. Although the exact pathogenesis is unclear, the literature suggests that increased risk of thromboembolic events in such patients occurs as a result of increased coagulation factors, inflammatory cytokines, and reduction in anticoagulants leading to a prothrombotic state.
Aim: To assess the prevalence, risk factors, management, and outcome of ulcerative colitis (UC) patients who develop VTE.
Methods: This was a retrospective chart review done in The Gastroenterology Department of The Aga Khan University Hospital. Data was collected from …

Exploring Adolescents' Mental Health In Kampala, Uganda In The Context Of Covid-19: A Mixed Methods Study, Gideon Mbithi, Ahmed Sarki, Adam Mabrouk, Rachel Odhiambo, Mary Namuguzi, Joseph Atukwatse, Margaret Kabue, Stephen Mulupi, Amina Abubakar

Institute for Human Development, East Africa

Background: Urban areas, particularly in developing nations like Uganda, face heightened risks due to poverty, unemployment, and environmental challenges, intensifying the vulnerability of urban youth to poor mental health. This study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 pandemic in Kampala City, Uganda.

Methods: We conducted a cross-sectional survey of 500 adolescents aged 13–19 years residing within the five divisions of Kampala City, Uganda. We utilized standardized psychological assessment tools including the Patient Health Questionnaire, Generalized Anxiety Scale, …

Air Pollution Exposures In Early Life And Brain Development In Children (Abc): Protocol For A Pregnancy Cohort Study, Sarah Benki-Nugent, Faridah H. Were, Anne M Riederer, Michael Gatari, Cj Karr, Edmund Yw Seto, Beatrice C. Mutai, Susan Wamithi, Brent R. Collett, John Kinuthia

Paediatrics and Child Health, East Africa

Introduction Air pollution is linked with poor neurodevelopment in high-income countries. Comparable data are scant for low-income countries, where exposures are higher. Longitudinal pregnancy cohort studies are optimal for individual exposure assessment during critical windows of brain development and examination of neurodevelopment. This study aims to determine the association between prenatal ambient air pollutant exposure and neurodevelopment in children aged 12, 24 and 36 months through a collaborative, capacity-enriching research partnership.

Methods and analysis This observational cohort study is based in Nairobi, Kenya. Eligibility criteria are singleton pregnancy, no severe pregnancy complications and maternal age 18 to 40 years. At …

Evaluating The Efficacy Of Diabetes Nurse-Led Health Coaching Intervention For Type 2 Diabetes At Aga Khan University Hospital, Nairobi: A Randomised Controlled Study, Jane Mugo

MSc in Advanced Practice Nursing

Background: Type 2 Diabetes (T2DM) has placed a significant burden on both healthcare systems and individuals living with the disease. However, it is preventable through health promotion strategies. Healthy behavior changes, which improve disease outcomes, highlight the importance of supporting and sustaining self-efficacy in diabetes self-management.

Objective: This study aimed to test the effectiveness of a nurse-led health coaching program on diabetes control for individuals with T2DM with HbA1c >6.5% specifically on glycated haemoglobin (HbA1c) levels as compared with standard diabetes care only.

Methodology: The study adopted a randomized controlled trial (RCT) with two groups: an intervention group receiving the …

Life Span Policies And Macroeconomic Transition Will Help The 21st-Century Brain Health Revolution In Developing Countries, Cyprian Mostert, Chinedu Momoh, Manasi Kumar, Shehzad Ali, Kendi Muchungi, Gloria Chemutai, Cynthia Smith, Dominic Trepel, Harris Eyre, Lukoye Atwoli

Brain and Mind Institute

In 2022, the World Health Organization (WHO) issued the Intersectoral Global Action Plan for Epilepsy and Other Neurological Disorders for 2022 to 2031, emphasizing important connections between brain health, population well-being, and economic growth. A year later, the WHO followed up with strategic guidelines aimed at enhancing brain health outcomes in developing countries. However, critical gaps remain. Our policy forum paper advocates for policies that target brain health across all stages of life, starting with measures to reduce the consumption of alcohol, sugar, and tobacco. Additionally, we propose the integration of school meal programs and social pension schemes as essential …

Cete Newsletter Volume 3, Tasbeeh Fayaz

Centre of Excellence for Trauma and Emergencies (CETE) Archives

This semiannual newsletter (Volume 3) from the Centre of Excellence for Trauma and Emergencies (CETE) at Aga Khan University highlights the Centre’s milestones and initiatives in 2024. It features messages from CETE’s leadership, updates on the Pakistan Life Savers Programme (PLSP), new partnerships, climate change advocacy, and community-based disaster preparedness. The issue also showcases CETE’s groundbreaking research projects, including the Trauma Registry, CONNECT-HTN, FEAMER telemedicine trial, Equi-Injury, iRise, and the EMS Data System. Special features include curriculum integration of life-saving skills in Sindh textbooks, the landmark #CPRUnitedPakistan event training 6,000 students simultaneously, and capacity-building programs for Lady Health Workers and …

Exploring News Consumption Habits Of Female Audiences And Impact On Media Sustainability., Anne Njeri Kanina

Master of Arts in Digital Journalism

This study sought to advance research in understanding audiences by exploring the news consumption and avoidance habits of male and female audiences and their impact on media sustainability in Kenya. The study used a mixed-method approach for data collection. The study collected primary data from 81 employees working at the University of Nairobi-Main Campus in the teaching, non-teaching, and support departments who completed an online survey questionnaire through the Google Docs platform. The Statistical Package for the Social Sciences (SPSS) software program and Microsoft Excel were used in the data analysis. The study also conducted in-depth interviews at the Nation …

Journalists Perception Of The Effectiveness Of Wellness Programs At Vision Group, Edna Ruth Mubiru

Executive Masters in Media Leadership and Innovation

Employee wellness is increasingly recognized as critical to organizational success. This study investigates employee perceptions of wellness programs at Vision Group, Uganda’s largest media house. With over 200 editorial staff, Vision Group operates in a high-pressure environment characterized by tight deadlines and financial constraints. Midst growing evidence linking wellness to productivity, this research evaluates the types, effectiveness and potential improvements for wellness initiatives at Vision Group. The study utilizes a cross-sectional design with mixed qualitative and quantitative approaches. Data collection includes a survey of editorial staff, an interview with the Human Resources personnel and analysis of secondary data such as …

Intersection Between Individual, Household, Environmental And System Level Factors In Defining Risk And Resilience For Children In Kenya’S Asal: A Qualitative Study, Esther Chongwo, Barack Aoko, Martha Kaniala, Moses Wesala, Phillis Magoma, Eunice Njoroge, Susan Nyamanya, Joyce Marangu, Anil Khamis, Amina Abubakar

Institute for Human Development, East Africa

Introduction: Children growing up in arid and semi-arid regions of Sub-Saharan Africa (SSA) face heightened risks, often resulting in poor developmental outcomes. In Kenya, the arid and semi-arid lands (ASAL) exhibit the lowest health and developmental indicators among children. Despite these risks, some children grow up successfully and overcome the challenges. However, there is limited comprehensive data on sources of risks and resilience in these children, particularly research that incorporates community perspectives and indigenous knowledge. Systematic documentation of factors influencing child outcomes is crucial for understanding the overall burden, informing policy and implementing targeted interventions. This study aimed at …

The Aga Khan Health Services - International Newsletter No. 21, Aga Khan University

The Aga Khan Health Services Archives

• Dr. Mahler visits Aga Khan University

• Dutch Medical Team and Aga Khan Health Services Collaborate

• Hopkins Holmberg Appointed Executive Director

• Research on Delivery Traditions in Kisumu

• Health and Nutrition Workshop for Day Care Teachers in India

• Rotary Club Presents Wheel Chairs to Dar-e-Salaam Hospital

• Student Nurses Teach Nutrition to Mothers

• Upgrading of Janbai Maternity Home Completed in Karachi

• First Midwifery Graduation at University Campus

• Dr. Cheves McCord Smythe

• Islamic Medicine After Ibn Sina

• Premier Tobacco and Pakistan Petroleum Support Aga Khan University

• Community Health Programme Launched in …

Academic Proficiency In Ugandan Children With Sickle Cell Anemia: A Cross-Sectional Study, Robert Opoka, Shubaya Kasule Naggayi, Paul Bangirana, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Ann Jacqueline Nakitende, Dennis Kalibbala

Paediatrics and Child Health, East Africa

Introduction: Academic proficiency is crucial for advancing learning goals, school advancement, and future economic security. Children with sickle cell anemia (SCA) in sub-Saharan Africa (SSA) may be at risk of disease-associated learning difficulties. Limited data exist on this topic among school-age children in the region. We aimed to assess academic proficiency in a sample of children with SCA in Uganda compared with unaffected controls.

Methods: This cross-sectional study was conducted in Kampala, Uganda. Participants were school-going children with SCA, aged 6–12 years, attending Mulago Hospital SCA Clinic, and age-matched sibling controls without SCA. Academic proficiency was assessed by the Wide …

Cure Newsletter Volume 4 Issue 2, Department Of Oncology

Cancer Updates Research & Education (CURE) Archives

• Message from the Chair
• Conferences & Workshops
• Conferences & Workshops
• Invited Talk
• Events and Celebrations
• Umeed Parr
• Awards and Achievements
• Oncology Social Media
• Oncology CPSP
• Residents & Fellows
• Spotlight on Faculty Contributions
• Nursing Oncology
• Nursing Awards Oncology Appreciation Evening 2024
• Upcoming Events Oncology
• Appointments
• Promotions
• Publications

Female Brain And Endocrinological Research–Veteran (Fember-Vet) Study: A Study Protocol For Identifying Endocrinological, Lifestyle And Psychosocial Determinants Of Brain Health Outcomes In Female Veterans For Future Intervention Success, Tamlyn Watermeyer, Elliott Atkinson, Glyn Howatson, Gill Mcgill, Christina Dodds, Paul Ansdell, Chinedu Momoh

Brain and Mind Institute

Background: Recent studies have demonstrated a greater risk of dementia in female veterans compared to civilians; with the highest prevalence noted for former service women with a diagnosis of psychiatric (trauma, alcoholism, depression), and/or a physical health condition (brain injury, insomnia, diabetes). Such findings highlight the need for increased and early screening of medical and psychiatric conditions, and indeed dementia, in the female veteran population. Further, they call for a better understanding of the underlying biopsychosocial mechanisms that might confer heightened risk for female veterans, to tailor preventative and interventional strategies that support brain health across the lifespan.

Methods …

Pathways To Nursing And Midwifery Education In Tanzania With Reflection To The Global Perspectives: A Narrative Review, Tumbwene Mwansisya, Mary Lyimo, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background/Objectives:

This review aimed to explore the pathways of nursing and midwifery education in Tanzania and compare them with global perspectives. The goal was to identify similarities, differences, and areas for potential improvement to align with international standards.

Methods:

A narrative literature review was carried out through databases with published studies in nursing and gray literature. The database search included Medline, PubMed, Google Scholar, EBSCO, PsycINFO, clinical nursing, and gray literature from January 2014 up to December 2024. The search process was carried out by the authors with the following key words: admission, pathway to nursing profession, delivery mode, …

Extension For Community Healthcare Outcomes-Palliative Care In Africa And Quality Of Life, Symptoms, Patient Experience, And Caregiver Distress Among Patients With Cancer, Sriram Yennurajalingam, Olaitan Soyannwo, John Weru, Edwina Beryl, Henriette Burger, Esther Nafulah, Oladayo Aikomo, Adeniyi Adenipekun, Irene Botchway, Mary Ocansey

Haematology and Oncology, East Africa

Purpose: In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model–Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.

Methods: ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation …

Nutritional Management Of Low Birth Weight And Preterm Infants In Low- And Low Middle-Income Countries, Maha Azhar, Rahima Yasin, Sawera Hanif, Sharib Afzal Bughio, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Introduction: Preterm and low birth weight (LBW) infants are at an increased risk of morbidity and mortality compared with their term counterparts, with more than 20 million LBW infants born each year, the majority in lower middle-income countries (LMICs). Given the increased vulnerability and higher nutritional needs of these infants, optimizing feeding strategies may play a crucial role in improving their health outcomes.
Methods: We updated evidence of Every Newborn Series published in The Lancet 2014 by identifying relevant systematic reviews, extracting low-income country (LIC) and LMIC data, and conducting revised meta-analysis for these contexts.
Results: We found 15 reviews; …