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The Burden of Critical Illness in Hospitalized Children in Low- and Middle-Income Countries: Protocol for a
Teresa B Kortz1,2, Katie R Nielsen3,4, Rishi P Mediratta5
1Division of Critical Care, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States.
Insights
Pediatric critical illness is a major cause of childhood deaths in low- and middle-income countries (LMICs). This systematic review quantifies the burden of pediatric critical illness and mortality in LMICs to guide interventions and reduce child mortality.
Area of Science:
- Global Health
- Pediatric Critical Care
- Epidemiology
Background:
- Childhood mortality is disproportionately high in low- and middle-income countries (LMICs).
- Many of these deaths are preventable with essential critical care interventions.
- Understanding the scope of pediatric critical illness in LMICs is crucial for effective intervention strategies.
Purpose of the Study:
- To systematically review and meta-analyze the existing literature.
- To determine the burden of hospitalization and mortality related to acute pediatric critical illness in LMICs.
Main Methods:
- Comprehensive search of multiple databases (MEDLINE, EMBASE, CINAHL, LILACS) using relevant keywords.
- Inclusion of observational studies published since January 1, 2005, focusing on hospitalized infants and children (28 days to 12 years) in LMICs.
- Exclusion of non-original data sources like editorials and conference materials.
Main Results:
- Data extraction will encompass study, hospital, and patient characteristics, along with outcomes and risk of bias.
- Analysis will report causes of admission and mortality stratified by region, country income level, and age.
- Case fatality rates (CFR) will be reported or calculated for specific diagnoses where data permit.
Conclusions:
- Quantifying the burden of pediatric critical illness in LMICs is essential for targeted interventions.
- Findings will inform resource allocation and investment decisions.
- Improved understanding will enhance the management and outcomes for critically ill children in LMICs.
Background:
The majority of childhood deaths occur in low- and middle-income countries (LMICs). Many of these deaths are avoidable with basic critical care interventions. Quantifying the burden of pediatric critical illness in LMICs is essential for targeting interventions to reduce childhood mortality.
Objective:
To determine the burden of hospitalization and mortality associated with acute pediatric critical illness in LMICs through a systematic review and meta-analysis of the literature.
Data Sources And Search Strategy:
We will identify eligible studies by searching MEDLINE, EMBASE, CINAHL, and LILACS using MeSH terms and keywords. Results will be limited to infants or children (ages >28 days to 12 years) hospitalized in LMICs and publications in English, Spanish, or French. Publications with non-original data (e.g., comments, editorials, letters, notes, conference materials) will be excluded.
Study Selection:
We will include observational studies published since January 1, 2005, that meet all eligibility criteria and for which a full text can be located.
Data Extraction:
Data extraction will include information related to study characteristics, hospital characteristics, underlying population characteristics, patient population characteristics, and outcomes.
Data Synthesis:
We will extract and report data on study, hospital, and patient characteristics; outcomes; and risk of bias. We will report the causes of admission and mortality by region, country income level, and age. We will report or calculate the case fatality rate (CFR) for each diagnosis when data allow.
Conclusions:
By understanding the burden of pediatric critical illness in LMICs, we can advocate for resources and inform resource allocation and investment decisions to improve the management and outcomes of children with acute pediatric critical illness in LMICs.
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