Needle and syringe programs for reducing blood-borne diseases among people who inject drugs in sub-Saharan Africa: a scoping review protocol.

OBJECTIVE: This review will identify, explore, and map the literature on the characteristics and implementation modalities of needle and syringe programs for reducing blood-borne diseases among people who inject drugs in sub-Saharan Africa compared with the recommended standards by the World Health Organization and AIDS Projects Management Group. INTRODUCTION: Sub-Saharan Africa bears a disproportionate burden of infectious diseases and HIV/AIDS. Needle and syringe programs have been shown to be effective in preventing transmission of infections among those who inject drugs by providing them with sterile injection equipment. The programs may also serve as avenues for addressing other issues that affect this population. INCLUSION CRITERIA: This review will consider published and unpublished studies on needle and syringe programs as a method of preventing blood-borne infections among people who inject drugs in sub-Saharan Africa. The review will consider quantitative, qualitative, and mixed methods study designs, as well as systematic reviews and text and opinion papers. METHODS: The electronic databases to be searched include MEDLINE, African Journals Online, CINAHL, the Cochrane Library, Embase, and TRoPHI. We will also search sources of unpublished studies and gray literature (conference abstracts, theses, etc). The search will be restricted to studies in English, with no date limit. Data extraction will be done by two independent reviewers, guided by an extraction tool developed by the reviewers. Key information, such as author, reference, and findings relevant to the review questions, will be obtained. The results will be presented as graphs, figures, and tables accompanied by a narrative summary.

Prevalence of burnout among nurses in sub-Saharan Africa: a systematic review.

OBJECTIVE: The objective of this review was to determine the prevalence rates for burnout among nurses working in countries within the sub-Saharan Africa region. INTRODUCTION: Burnout is a response to chronic work-related stress. While there is ample information on its prevalence and risk factors in well-resourced settings in high-income countries, it remains poorly studied in the low- and middle-income countries of sub-Saharan Africa, which bear the larger share of the global burden of disease. INCLUSION CRITERIA: This review considered studies from sub-Saharan Africa that identified the prevalence of burnout among nurses using standard measurement tools. METHODS: A three-step search strategy was utilized to identify both published and unpublished studies in English. Databases (MEDLINE, Embase, CINAHL, and others) were searched from inception to January 2019. Study selection, critical appraisal, data extraction, and data synthesis were conducted according to JBI methodology. RESULTS: A total of 12 studies (n = 2543 nurses) from seven African countries were included in this review. Eight of these studies were cross-sectional by design while the others were either exploratory, longitudinal, surveys, or descriptive. Ten studies were deemed to be at low risk of bias. According to the Maslach Burnout Inventory (seven studies, n = 1923), the prevalence of emotional exhaustion was 66% (95% confidence interval [CI], 37% to 89%), 60% (95% CI, 31% to 85%) for depersonalization, and 49% (95% CI, 19% to 80%) for low personal achievement. The overall prevalence of burnout among studies that utilized the Professional Quality of Life Scale (three studies, n = 337) was 87% (95% CI, 54% to 100%). One study reported a prevalence of 51% (95% CI, 44% to 57%) using the Copenhagen Burnout Inventory (n = 237), and the final study reported a prevalence of 33% (95% CI, 21% to 47%) using an unspecified measuring tool (n = 46). CONCLUSIONS: Regardless of the measuring tool used, nurses in sub-Saharan Africa experience high levels of burnout in all its dimensions.