Biotechnology Center, Universite de Yaounde I, Yaounde, Cameroon.
National AIDS Control Committee, Cameroon.
BMJ Open. 2019 Jun 21;9(6):e023937. doi: 10.1136/bmjopen-2018-023937.
INTRODUCTION: HIV-exposed uninfected (HEU) children have higher morbidity and mortality compared with HIV unexposed uninfected children. Despite the fact that malnutrition contributes to about half of all infant deaths below 5 years of age in low-income and middle-income countries and that growth impairment has been reported in the HEU population, the spectrum of growth disorders associated with HIV and antiretroviral therapy (ART) exposure during the in utero and perinatal periods is yet to comprehensively summarised among the global HEU population. This protocol for a systematic review and meta-analysis aims to critically synthesise data concerning the prevalence of underweight, stunting and wasting at different ages in the global HEU population. METHODS AND ANALYSIS: Medline, EMBASE, Cochrane Library, TOXLINE, WHO Global Index Medicus and the Web of Science will be searched for relevant articles published between 1 January 1989 and 1 December 2017 without language restriction. In addition, conference abstracts and reference lists of eligible papers and relevant review articles will be screened. Authors will screen and select studies, extract data, assess the risk of bias as well as studies individually for heterogeneity. Study-specific estimates will be pooled through a random-effects meta-analysis model for studies that are clinically homogeneous while funnel plots and Egger's test will be used to detect publication bias. Results will be presented by ART availability period, country income levels and mode of breastfeeding. ETHICS AND DISSEMINATION: Ethical approval will not be required for this study because it will be based on published data. The final report of this study will be published in a peer-reviewed journal and presented at scientific conferences. This review will summarise the evidence and quantify the problem of growth impairment in HEU infants and so shed more light on our understanding of the higher morbidity and mortality in this growing population. PROSPERO REGISTRATION NUMBER: CRD42018091762.
简介:与未感染 HIV 的儿童相比,HIV 暴露未感染(HEU)儿童的发病率和死亡率更高。尽管在低收入和中等收入国家,营养不良导致了 5 岁以下儿童死亡的一半左右,并且在 HEU 人群中已经报道了生长障碍,但与 HIV 和抗逆转录病毒治疗(ART)在宫内和围产期暴露相关的生长障碍谱尚未在全球 HEU 人群中得到全面总结。本系统评价和荟萃分析的方案旨在批判性地综合数据,说明在全球 HEU 人群中不同年龄的体重不足、发育迟缓、消瘦的流行率。
方法和分析:将在 1989 年 1 月 1 日至 2017 年 12 月 1 日期间,无语言限制地在 Medline、EMBASE、Cochrane 图书馆、TOXLINE、世界卫生组织全球索引医学和 Web of Science 上搜索相关文章。此外,还将筛选会议摘要和合格论文和相关综述文章的参考文献列表。作者将筛选和选择研究,提取数据,评估个体研究的偏倚风险和异质性。对于临床同质的研究,将通过随机效应荟萃分析模型对研究特异性估计值进行汇总,同时使用漏斗图和 Egger 检验来检测发表偏倚。结果将按 ART 可获得期、国家收入水平和母乳喂养方式呈现。
伦理和传播:本研究不需要伦理批准,因为它将基于已发表的数据。本研究的最终报告将发表在同行评议的期刊上,并在科学会议上报告。本综述将总结证据,并量化 HEU 婴儿生长障碍的问题,从而更深入地了解这一不断增长的人群中更高发病率和死亡率的原因。
PROSPERO 注册号:CRD42018091762。
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