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. 2022 Mar 16:10:756643.
doi: 10.3389/fped.2022.756643. eCollection 2022.

The Burden of Critical Illness in Hospitalized Children in Low- and Middle-Income Countries: Protocol for a Systematic Review and Meta-Analysis

Teresa B Kortz  1   2 , Katie R Nielsen  3   4 , Rishi P Mediratta  5 , Hailey Reeves  2 , Nicole F O'Brien  6 , Jan Hau Lee  7   8 , Jonah E Attebery  9 , Emaan G Bhutta  10 , Carter Biewen  1 , Alvaro Coronado Munoz  11 , Mary L deAlmeida  12 , Yudy Fonseca  13 , Shubhada Hooli  14 , Hunter Johnson  6 , Niranjan Kissoon  15   16 , Mara L Leimanis-Laurens  17   18 , Amanda M McCarthy  11 , Carol Pineda  19 , Kenneth E Remy  20   21 , Sara C Sanders  6 , Yemisi Takwoingi  22   23 , Matthew O Wiens  24   25 , Adnan T Bhutta  13
Affiliations

The Burden of Critical Illness in Hospitalized Children in Low- and Middle-Income Countries: Protocol for a Systematic Review and Meta-Analysis

Teresa B Kortz et al. Front Pediatr. .

Abstract

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.

Keywords: child health; critical illness; global health; hospitalization; low- and middle-income countries (LMIC); pediatrics—children; resource limited setting.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer YHM declared a shared affiliation with one of the authors JL to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) flowchart for title and abstract screening and text selection from the final search (conducted March 1, 2021).
Figure 2
Figure 2
Approach to screening abstracts, titles and texts for eligibility. LMIC, low- and middle-income country; SDI, Socio-Demographic Index; NICU, neonatal intensive care unit; PICU, pediatric intensive care unit.
See this image and copyright information in PMC

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