Aspiration Pneumonia Among Stroke Patients in Ethiopia: Systematic Review and Meta-Analysis
Journal Article
Addisu Getie a,*, Manay Ayalneh b, Melaku Bimerew b, Adam Wondmieneh b
Submitted: Jun 28, 2024
College of Health Science
Nursing
Abstract Preview:
Introduction: One of the main complications for stroke patients is aspiration pneumonia, which is an acute lunginfection brought on by the entry of endogenous flora and various bodily substances from the gastrointestinaltract into the respiratory system. Aspiration pneumonia following a stroke was linked to older age, gender,dysarthria, denture use, cerebral atrophy, and basal ganglia-infarcted foci. Despite improvements in care, theepidemiological and prognostic effects of pneumonia associated with stroke are increasing mortality andmorbidity.Objective: To assess the pooled prevalence of aspiration pneumonia among stroke patients in Ethiopia.Methods: Several databases, including PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, African JournalsOnline (AJOL), grey literature, and articles from the repository of Ethiopian universities, were examined to findavailable articles. The data were extracted and sorted in Microsoft Excel and exported to STATA/MP 17.0 foranalysis. The Newcastle-Ottawa (NOS) was employed to assess each study’s qualities. A weighted inverse vari-ance random-effects model with a 95 % confidence interval was used to examine the pooled prevalence ofaspiration pneumonia. The Galbraith plot and funnel plot were used to evaluate heterogeneity and publicationbias, respectively. To identify the possible cause of heterogeneity, subgroup analysis and meta-regression wereperformed. P-values less than 0.05 were considered statistically significant.Result: The pooled prevalence of aspiration pneumonia among stroke patients in Ethiopia was 31.65 % (95 % CI:25.30–38.01). Visual examination of the Galbraith plot reveals the presence of significant heterogeneity (I2 =96.55 %, p < 0.001). Studies conducted in Addis Ababa and Harar revealed the highest prevalence of aspirationpneumonia: 37.67 % (95 % CI: 31.56, 43.78). Similarly, articles carried out before 2020 and studies done usingcross-sectional study design revealed the highest proportion of aspiration pneumonia: 32.97 % (95 % CI: 24.96,40.98) and 36.75 (95 % CI: 32.11, 41.38), respectively.Conclusion: Nearly one-third of stroke patients developed aspiration pneumonia. The highest prevalence wasreported in Addis Ababa and Harar regions. As a result, early detection, treatment, and control of stroke areadvisable to prevent the occurrence of aspiration pneumonia.
Keywords: Aspiration pneumonia, Stroke, Cerebrovascular accident, Systematic review, Meta-analysis, Ethiopia
Full Abstract:
Introduction: One of the main complications for stroke patients is aspiration pneumonia, which is an acute lunginfection brought on by the entry of endogenous flora and various bodily substances from the gastrointestinaltract into the respiratory system. Aspiration pneumonia following a stroke was linked to older age, gender,dysarthria, denture use, cerebral atrophy, and basal ganglia-infarcted foci. Despite improvements in care, theepidemiological and prognostic effects of pneumonia associated with stroke are increasing mortality andmorbidity.Objective: To assess the pooled prevalence of aspiration pneumonia among stroke patients in Ethiopia.Methods: Several databases, including PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, African JournalsOnline (AJOL), grey literature, and articles from the repository of Ethiopian universities, were examined to findavailable articles. The data were extracted and sorted in Microsoft Excel and exported to STATA/MP 17.0 foranalysis. The Newcastle-Ottawa (NOS) was employed to assess each study’s qualities. A weighted inverse vari-ance random-effects model with a 95 % confidence interval was used to examine the pooled prevalence ofaspiration pneumonia. The Galbraith plot and funnel plot were used to evaluate heterogeneity and publicationbias, respectively. To identify the possible cause of heterogeneity, subgroup analysis and meta-regression wereperformed. P-values less than 0.05 were considered statistically significant.Result: The pooled prevalence of aspiration pneumonia among stroke patients in Ethiopia was 31.65 % (95 % CI:25.30–38.01). Visual examination of the Galbraith plot reveals the presence of significant heterogeneity (I2 =96.55 %, p < 0.001). Studies conducted in Addis Ababa and Harar revealed the highest prevalence of aspirationpneumonia: 37.67 % (95 % CI: 31.56, 43.78). Similarly, articles carried out before 2020 and studies done usingcross-sectional study design revealed the highest proportion of aspiration pneumonia: 32.97 % (95 % CI: 24.96,40.98) and 36.75 (95 % CI: 32.11, 41.38), respectively.Conclusion: Nearly one-third of stroke patients developed aspiration pneumonia. The highest prevalence wasreported in Addis Ababa and Harar regions. As a result, early detection, treatment, and control of stroke areadvisable to prevent the occurrence of aspiration pneumonia.
Keywords: Aspiration pneumonia, Stroke, Cerebrovascular accident, Systematic review, Meta-analysis, Ethiopia