Figure 1

<p>Study flow diagram.</p

Acute Myocardial Infarction in Sub-Saharan Africa: The Need for Data

<div><p>Background</p><p>Trends in the prevalence of acute myocardial infarction in sub-Saharan Africa have not been well described, despite growing recognition of the increasing burden of cardiovascular disease in low- and middle-income countries. The aim of this systematic review was to describe the prevalence of acute myocardial infarction in sub-Saharan Africa.</p><p>Methods</p><p>We searched PubMed, EMBASE, Global Health Archive, CINAHL, and Web of Science, and conducted reference and citation analyses. Inclusion criteria were: observational studies, studies that reported incidence or prevalence of acute myocardial infarction, studies conducted in sub-Saharan Africa, and studies that defined acute myocardial infarction by EKG changes or elevation of cardiac biomarkers. Studies conducted prior to 1992 were excluded. Two independent reviewers analyzed titles and abstracts, full-texts, and references and citations. These reviewers also performed quality assessment and data extraction. Quality assessment was conducted with a validated scale for observational studies.</p><p>Findings</p><p>Of 2292 records retrieved, seven studies met all inclusion criteria. These studies included a total of 92,378 participants from highly heterogeneous study populations in five different countries. Methodological quality assessment demonstrated scores ranging from 3 to 7 points (on an 8-point scale). Prevalence of acute myocardial infarction ranged from 0.1 to 10.4% among the included studies.</p><p>Interpretation</p><p>There is insufficient population-based data describing the prevalence of acute myocardial infarction in sub-Saharan Africa. Well-designed registries and surveillance studies that capture the broad and diverse population with acute myocardial infarction in sub-Saharan Africa using common diagnostic criteria are critical in order to guide prevention and treatment strategies.</p><p>Registration</p><p>Registered in International Prospective Register of Systematic Reviews (PROSPERO) Database #CRD42012003161.</p></div

Prevalence of MI among study populations of included studies.

<p>Prevalence of MI among study populations of included studies.</p

Figure 1

<p>Study flow diagram.</p

Studies characteristics.

<p>*Indicates whether all subjects were screened with an objective test (EKG or cardiac biomarkers) or if screening was performed only for those patients whom the clinician felt had symptoms concerning for possible AMI.</p

Figure 3

<p>Locations of studies of AMI in Sub-Populations of Sub-Saharan Africa.</p

Figure 2

<p>Methodological quality assessment of included studies.*Blue cells indicate a score of “1” (present) and white cells indicate a score of “0” (absent).</p

Factors That Drive Dentists towards or Away from Dental Caries Preventive Measures: Systematic Review and Metasummary

<div><p>Background</p><p>Dental caries is a serious public health concern. The high cost of dental treatment can be avoided by effective preventive measures, which are dependent on dentists’ adherence. This study aimed to evaluate the factors that drive dentists towards or away from dental caries preventive measures.</p><p>Methods and Findings</p><p>This systematic review was registered in PROSPERO (CRD42012002235). Several databases as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines, yielding 18,276 titles and abstracts, which were assessed to determine study eligibility. Seven qualitative studies and 41 surveys (36,501 participants) remained after data extraction and interpretation. A total of 43 findings were abstracted from the reports and were grouped together into 6 categories that were judged to be topically similar: education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. The main findings for adherence based on their calculated frequency effect sizes (ES) were teamwork (21%) and post-graduation (12%), while for non-adherence were biologicism (27%), and remuneration for preventive procedures (25%). Intensity ES were also calculated and demonstrated low prevalence of the findings. Quality assessment of the studies demonstrated that the methodological quality, particularly of surveys, varied widely among studies.</p><p>Conclusions</p><p>Despite the questionable quality of the included reports, the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general.</p></div

Heat map showing a gradient of quality indicators for each individual survey included in the analysis.

<p>Colors vary from white (No), light blue (Not Clear) and blue (Yes) representing the three categories used in the quality assessment.</p

Factors dentists believed to drive patients towards or away from performing preventive measures.

<p>Graph theory-based figure showing the relation among surveys included in the metasummary model. Squares represent the individual studies included, and circles the emerging factors. Size of each individual marking indicates its effect size in the model; larger markings being more recurrent. Studies presenting lower intensity ES (prevalence) appear further from the center, while studies with higher intensity ES closer to the center of the figure.</p