Mortality among non-severely under nourished children with pneumonia globally: protocol for a systematic review and meta-analysis

Damalie Nalwanga; Caitlin Bakker; Andrew Kiggwe; Abel Abera Negash; Moses Ocan; Andre Briend; Kathryn Maitland; Victor Musiiime; Charles Karamagi

doi:10.12688/wellcomeopenres.20200.1

Mortality among non-severely under nourished children with pneumonia globally: protocol for a systematic review and meta-analysis

Wellcome Open Res. 2024 Mar 14:8:551. doi: 10.12688/wellcomeopenres.20200.1. eCollection 2023.

Authors

Damalie Nalwanga^{1

2}, Caitlin Bakker³, Andrew Kiggwe², Abel Abera Negash^{4

5}, Moses Ocan⁶, Andre Briend^{7

8}, Kathryn Maitland^{9

10}, Victor Musiiime^#^{1

11}, Charles Karamagi^#^{1

12}

Affiliations

¹ Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Central Region, Uganda.
² Makerere University Lung Institute, Kampala, Central Region, Uganda.
³ University Libraries, University of Minnesota, Minneapolis, Minneapolis, USA.
⁴ Armauer Hansen Research Institute, Addis Ababa, Addis Ababa, Ethiopia.
⁵ Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia.
⁶ Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere University, Kampala, Central Region, Uganda.
⁷ School Of Medicine, University of Tampere, Tampere, Finland.
⁸ Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark.
⁹ Clinical, KERMI Wellcome Trust Research Programme, Kilifi, Kilifi, Po Box 230, Kenya.
¹⁰ Department of Infectious Disease and Institute of Global Health and Innovation, Imperial College London, London, England, UK.
¹¹ Research Department, Joint Clinical Research Centre, Kampala, Uganda.
¹² Clinical Epidemiology Unit, Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Central Region, Uganda.

^# Contributed equally.

Abstract

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).

Keywords: Undernutrition; children; mortality; nutritional supplementation; pneumonia.

Grants and funding

WT_/Wellcome Trust/United Kingdom