Aspiration pneumonia among stroke patients in Ethiopia: Systematic review and meta-analysis

Introduction

One of the main complications for stroke patients is aspiration pneumonia, which is an acute lung infection brought on by the entry of endogenous flora and various bodily substances from the gastrointestinal tract 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, the epidemiological and prognostic effects of pneumonia associated with stroke are increasing mortality and morbidity.

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 Journals Online (AJOL), grey literature, and articles from the repository of Ethiopian universities, were examined to find available articles. The data were extracted and sorted in Microsoft Excel and exported to STATA/MP 17.0 for analysis. The Newcastle-Ottawa (NOS) was employed to assess each study's qualities. A weighted inverse variance random-effects model with a 95 % confidence interval was used to examine the pooled prevalence of aspiration pneumonia. The Galbraith plot and funnel plot were used to evaluate heterogeneity and publication bias, respectively. To identify the possible cause of heterogeneity, subgroup analysis and meta-regression were performed. 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 aspiration pneumonia: 37.67 % (95 % CI: 31.56, 43.78). Similarly, articles carried out before 2020 and studies done using cross-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 was reported in Addis Ababa and Harar regions. As a result, early detection, treatment, and control of stroke are advisable to prevent the occurrence of aspiration pneumonia.