Method/Design
Systematic review framework
The protocol for this systematic review is founded on the PRISMA-P 2015 checklist (Moher et al, 2015).16 The systematic review will rely on the PRISMA guideline for systematic review (Moher, Liberati, Tetzlaff, Altman, & the PRISMA Group, 2009).17
Eligibility criteria
Studies will be included based on the following outlined criteria:
Study designs
We will include cross-sectional studies and cohort studies. Studies must have been published in peer-reviewed journals, in English language or in any other language but translated into English language by Google translator.
Participants
We will include studies that examined the prevalence and/or incidence of diabetes among adult (18 years or older) persons living with HIV (PLWH), risk factors of diabetes among persons living with HIV. We will exclude studies that examined persons less than 18 years of age or pregnant women.
Interventions or Concepts
Interventions or concepts of interest are, prevalence of diabetes, incidence of diabetes, risk factors of diabetes among persons living with HIV and associations between HIV infection/use of anti-retroviral therapy and prevalence of diabetes.
Comparators
- Prevalence of diabetes among the general populace will be compared with prevalence of diabetes among persons living with HIV of same gender and age brackets
- Risk factors for diabetes among general population will be compared with risk factors for diabetes among persons living with HIV of same gender and age brackets.
Timing
We will select and include studies based on how long the participant tested positive for HIV and how long has how long the participant has been of ARVs as follows:
- For the comparator group, participant must have tested positive for HIV for at least 1 year.
- For the study group, participant must be on ARVs for a minimum of 1 year
Setting
There will be no restriction by type of location or country of study. Therefore, studies from all settings will be included as long as such studies have met the inclusion criteria.
Language
We will include articles reported in English language and articles reported in any other language but can be translated into English language by google translator.
Information
Literature search approaches will be developed with medical subject headings (MeSH) and text words related HIV, diabetes, prevalence and risk factors. We will explore Pubmed, Medline, PsycInfo and EMBASE for articles to be included in the systematic review. Also manual searches will be conducted. Reference lists of incorporated studies or related reviews identified during the search will be examined to ensure literature saturation. We will also search the personal files of the authors in order to ensure that all relevant material has been incorporated. The dates for all searches will be noted and included in reporting the review. All literature searches will be done in English language but any relevant study in any language obtained from the searches that provided an option to be translated into English language will also be included. We will also contact authors of included studies in some clarification or additional information is required.
Search strategy
Draft Pubmed search
PubMed database will be searched for articles to identify relevant studies. Terms that will be used in differing combinations to locate a comprehensive list of articles are: HIV, HIV/AIDS, AIDS, Human Immunodeficiency Virus, Acquired immunodeficiency Syndrome, Diabetes, hyperglyc?mia, endocrine system disease, metabolic disease, glucose intolerance, diabetes mellitus, type 2 diabetes, type 1 diabetes, drug induced diabetes, prevalence, epidemiology, and incidence. Boolean operators AND as well as OR will be used for the database.
Study records
Data management
Results of literature search s will be uploaded to Distiller Systematic Review (DSR) software or Eppi reviewer, depending on which one the reviewers are familiar with (these are internet based software programmes), to facilitate collaboration among reviewers during study selection procedure. The reviewers will work together to build up, test, pilot and refine the screening questions and form for evaluations based on the inclusion and exclusion criteria. Citation abstracts and full text articles will be uploaded along with screening questions to DRS or Eppi reviewer as preferred by the reviewers. To avoid including duplicate publications, studies will be arranged based on authors and remove duplicate publications.
Selection process:
The reviewers will carry out an independent screening of the titles and abstracts that are obtained from the search against the inclusion criteria of the systematic review. We will acquire full texts for all titles that appear to meet the inclusion criteria or where there is any form of ambiguity. Reviewers will then conduct an independent screening of the full text reports and decide if these conform to the inclusion criteria. We will seek further data from study authors where required, to answer questions about eligibility. We will resolve discrepancies through deliberations; conclusions will be drawn based on the positions of the majority of the reviewers. We will document the basis for excluding studies. We will then measure the quality of every study that met the inclusion criteria as explained, with the use of the quality assessment tool for observational cohort and cross-sectional studies as developed by the National Heart, Lung, and Blood Institute (2014); which consists of 14 yes/no questions. After that data will be obtained from all the studies that passed the quality assessment test.
Data collection process:
We will extract the following data into a table using Microsoft Word (Microsoft Corporation, Redmond, WA), the title of the study, the author(s), the study design, the purpose of the study, sample size, the study setting, mean age of the study sample, gender distribution, prevalence of diabetes, incidence of diabetes and risk factors of diabetes. Data fields in the table will include ‘title and author(s)’, ‘design and purpose’, ‘sample and setting’, this will include the sample size, mean age, gender distribution and study setting, ‘prevalence/incidence of diabetes in PLWH’, and ‘risk factors for diabetes in PLWH’. This process will be done independently by each reviewer.
Data items
We obtain the following information from included studies: The journal where study was published (only studies published in pair reviewed journals will be included), the title of the study, the author(s), the study design (only cohort and cross sectional studies will be included), the purpose of the study, sample size, the study setting, mean age of the study sample, gender distribution, prevalence of diabetes, incidence of diabetes and risk factors of diabetes.