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

• Published in: Frontiers in pediatrics 2022-03, Vol.10, p.756643-756643
• Main Authors: Kortz, Teresa B, Nielsen, Katie R, Mediratta, Rishi P, Reeves, Hailey, O'Brien, Nicole F, Lee, Jan Hau, Attebery, Jonah E, Bhutta, Emaan G, Biewen, Carter, Coronado Munoz, Alvaro, deAlmeida, Mary L, Fonseca, Yudy, Hooli, Shubhada, Johnson, Hunter, Kissoon, Niranjan, Leimanis-Laurens, Mara L, McCarthy, Amanda M, Pineda, Carol, Remy, Kenneth E, Sanders, Sara C, Takwoingi, Yemisi, Wiens, Matthew O, Bhutta, Adnan T
• Format: Article
• Language: English
• Subjects: child health; critical illness; global health; hospitalization; Pediatrics; pediatrics—children; resource limited setting
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2022.756643

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. 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. 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. 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 will include information related to study characteristics, hospital characteristics, underlying population characteristics, patient population characteristics, and outcomes. 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. 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.