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Mortality among non-severely under nourished children with pneumonia globally: protocol for a systematic review and
Damalie Nalwanga1,2, Caitlin Bakker3, Andrew Kiggwe2
1Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Central Region, Uganda.
Insights
Pneumonia impacts child health globally. This review examines mortality and nutritional status in non-severely malnourished children with pneumonia, and the effects of nutritional supplementation.
Area of Science:
- Pediatrics
- Global Health
- Nutritional Science
Background:
- Pneumonia is a leading cause of child mortality worldwide.
- Severe malnutrition exacerbates pneumonia's mortality risk.
- The impact of pneumonia on non-severely malnourished children and the role of nutritional supplementation require further investigation.
Purpose of the Study:
- To review evidence on mortality and anthropometric outcomes in non-severely malnourished children with pneumonia.
- To assess the impact of nutritional supplementation on mortality and nutritional status in this population.
- To inform strategies for improving clinical outcomes in children with pneumonia.
Main Methods:
- Systematic review following PRISMA guidelines.
- Comprehensive literature search across multiple databases and grey literature.
- Data extraction and analysis using narrative and quantitative synthesis, including random-effects modeling.
Main Results:
- This review will provide baseline data on pneumonia outcomes in non-severely malnourished children.
- It will elucidate the effects of nutritional supplementation on mortality and anthropometry.
- Findings will highlight potential interventions for improving child survival and nutritional status.
Conclusions:
- Evidence on pneumonia's impact on non-severely malnourished children is limited.
- Nutritional supplementation may improve outcomes in this vulnerable group.
- Further research is needed to optimize interventions for childhood pneumonia.
Background:
Pneumonia remains the commonest cause of ill health and mortality among children worldwide. Severe undernutrition increases the mortality risk among children with pneumonia. While children with pneumonia are at increased risk of developing malnutrition, the impact of pneumonia on mortality and nutritional status of non-severely undernourished children is not well described. The impact of nutritional supplementation on mortality and nutritional status in this population is not well understood. This review will collate available evidence on the all-cause mortality and anthropometric indices outcomes following pneumonia, as well as the impact of nutritional supplementation on mortality and anthropometry among non-severely malnourished children with pneumonia.
Methods:
The review will be done using a priori criteria developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Data will be obtained from data bases, grey literature, and bibliographies. An experienced librarian will conduct article search in PUBMED, MEDLINE, EMBASE, Web of Science, Google scholar, and Scopus. Retrieved articles will be entered in Endnote ver 9.0, duplicates removed, and transferred to Epi-reviewer for screening and data abstraction. Risk of bias in the included articles will be assessed using standard criteria. Heterogeneity will be assessed using I 2-statistic and sub-group analysis will be done. Data will be analysed using both narrative and quantitative synthesis. Quantitative synthesis will be done using DeSimonian and Laird Random-effects model in STATA ver 15.0.
Conclusions:
The results will provide baseline information about the mortality and anthropometric outcomes of pneumonia among non-severely malnourished children as well as the potential effect of nutritional supplementation on these outcomes. This will provide a basis to explore the potential for nutritional supplementation improving clinical outcomes like mortality and occurrence of severe acute malnutrition among children with severe pneumonia worldwide.
Registration:
The review has been registered in PROSPERO (CRD42021257272; 15 July 2021).
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