{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:11:53Z","timestamp":1760818313045,"version":"build-2065373602"},"reference-count":50,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,16]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Sub-Saharan Africa remains the epicentre of the HIV pandemic, yet enormous knowledge gaps still exist to elicit a comprehensive portrait of multimorbidity and HIV linkage. This study aims to conduct a systematic meta-analysis of peer-reviewed literature to investigate the current status of multimorbidity epidemiology among people living with HIV (PLHIV) in sub-Saharan Africa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>Our review will assess observational studies (ie, cohort, case\u2013control and cross-sectional) on multimorbidity associated with HIV\/AIDS between 1 January 2005 and 31 October 2020 from sub-Saharan Africa. Databases to be searched include PubMed\/MEDLINE, Scopus, Web of Science, Cochrane library, African Index Medicus and African Journals Online. We will also search the WHO clinical trial registry and databases for systematic reviews. The search strategy will involve the use of medical subject headings and key terms to obtain studies on the phenomena of HIV and multimorbidity at high precision. Quality assessment of eligible studies will be ascertained using a validated quality assessment tool for observational studies and risk of bias through sensitivity analysis to identify publication bias. Further, data on characteristics of the study population, multimorbid conditions, epidemiological rates and spatial distribution of multimorbid conditions in PLHIV will be extracted. Heterogeneity of individual studies will be evaluated using the I<jats:sup>2<\/jats:sup> statistic from combined effect size estimates. The statistical analysis will be performed using STATA statistical software V.15 and results will be graphically represented on a forest plot.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethical approval is not applicable in this study as it is a systematic review of published literature. The review findings may also be presented at conferences or before other relevant stakeholders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42020148668.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-036988","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T02:45:14Z","timestamp":1607827514000},"page":"e036988","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Epidemiology of multimorbidity among people living with HIV in sub-Saharan Africa: a systematic review protocol"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0246-5595","authenticated-orcid":false,"given":"Kelechi Elizabeth","family":"Oladimeji","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, University of Fort Hare, East London, South Africa"},{"name":"College of Graduate Studies, University of South Africa, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armstrong","family":"Dzomba","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olatunji","family":"Adetokunboh","sequence":"additional","affiliation":[{"name":"DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa"},{"name":"Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindiwe","family":"Zungu","sequence":"additional","affiliation":[{"name":"College of Graduate Studies, University of South Africa, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanni","family":"Yaya","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Ter","family":"Goon","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Fort Hare, East London, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,12]]},"reference":[{"key":"2025101812332057000_10.12.e036988.1","unstructured":"Why the epidemic is not over. 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