Availability, accessibility and activation of mental health services among university students in Africa: a protocol of a mixed-methods systematic review with meta-analysis and meta-synthesis.

INTRODUCTION: In Africa, the prevalence of mental health problems is higher among university students than in the general population. A number of systematic reviews and recent prevalence studies have focused on prevalence of mental health issues among college. This mixed-methods systematic review, including meta-analysis and meta-synthesis, will explore: what mental health services are available to university students; the extent to which students access available services and factors associated with service access; and the degree to which students activate (use) accessible services and factors associated with service activation. METHODS AND ANALYSIS: We will conduct electronic literature search of the following databases: PubMed, Cochrane Library, Semantic Scholar, ERIC, Trip Database, Medline and PsycINFO. Disagreement, if any, will be resolved by a third reviewer. Two reviewers will independently assess the methodological quality of included studies using relevant tools. For cross-sectional studies, we will use the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies whereas qualitative or mixed-methods studies will be assessed using the Critical Appraisal Skills Programme. OR, risk ratio or mean difference with 95% CI will be considered as the effect size. We will assess heterogeneity between studies by appropriate subgroup analyses. Publication bias will be detected using funnel plots. ETHICS AND DISSEMINATION: Ethical clearance is not required as we are not collecting primary data. Findings will be disseminated via relevant scientific conferences and peer-reviewed publications. PROSPERO REGISTRATION NUMBER: CRD42022296870.

Factors associated with North-South research collaboration focusing on HIV/AIDS: lessons from ClinicalTrials.gov.

BACKGROUND: A North-South (N-S) research collaboration is one way through which research capacity of developing countries can be strengthened. Whereas N-S collaboration in HIV/AIDS area may result in research capacity strengthening of Southern partners, it is not clear what factors are associated with this type of collaboration. The study aims to characterize N-S research collaboration focusing on HIV/AIDS and to determine factors associated with such N-S research collaborations. METHODS: Clinical trial data on HIV/AIDS-related studies conducted between 2000 and 2019 were obtained from ClinicalTrials.gov. Using these data, we characterized N-S collaborative studies focusing on HIV/AIDS and summarized them using frequencies and percentages. To determine factors associated with these studies, we used logistic regression and reported results as adjusted odds ratios with Wald 95% confidence intervals. RESULTS AND DISCUSSION: Of the 4,832 HIV/AIDS-related studies retrieved from the registry, less than one-quarter (n = 1133, 23%) involved a Southern institution, with 77% of these studies classified as N-S collaborations. Majority of these studies have single PI (50%), are conducted at single location (39%); have large sample sizes (41%); are federally-funded (32%) or receive funding from other sources (32%); are intervention studies (64%); and involve a mixture of male and female participants (58%) and adult participants (54%). Single PIs (as opposed to multiple PIs) were more likely to be from the North than South institution (odds ratio = 5.59, 95%CI: 4.16 - 11.57). Trend analyses showed that N-S research collaborations produced HIV/AIDS-related studies at a faster rate than S-S research collaborations. N-S collaborations involving female or children produced HIV/AIDS-related studies between 2000 and 2019 at a significantly faster rate than S-S collaborations involving females and children during the same period. Holding other factors constant, N-S collaborative research focusing on HIV/AIDS are associated with: multiple PIs as opposed to single PI, multiple institutions as opposed to a single institution, multiple locations as opposed to a single location, large number of participants as opposed to small sample sizes, and public funding as opposed to industry funding. Almost half of these studies had a Northern PI only, about one-third had a Southern PI only, and much fewer had PIs from both North and South. However, these studies were less likely to receive funding from other sources than industry funding. CONCLUSIONS: HIV/AIDS-related research is increasingly becoming a more collaborative global research involving more N-S collaborations than S-S collaborations. Factors associated with N-S collaborative studies focusing on HIV/AIDS include multiple PIs, institutions, and locations; large sample sizes; publicly funded; and involve vulnerable populations such as women and children. Whereas almost half of these studies have a Northern PI only, about one-third have a Southern PI only, and much fewer have PIs from both North and South. Our results inform future design and implementation of N-S research collaborations in this area. Suggestions for improvement of ClinicalTrials.gov registry are provided.