Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, UK.
Malawi-Liverpool Wellcome Trust Clinical Research Programme, P.O. Box 30096, Chichiri, Blantyre, Malawi.
Syst Rev. 2021 Oct 29;10(1):282. doi: 10.1186/s13643-021-01796-1.
Non-traumatic coma is a common acute childhood presentation to healthcare facilities in Africa and is associated with high morbidity and mortality. Historically, the majority of cases were attributed to cerebral malaria (CM). With the recent drastic reduction in malaria incidence, non-malarial coma is becoming a larger proportion of cases and determining the aetiology is diagnostically challenging, particularly in resource-limited settings. The purpose of this study will be to evaluate the aetiology and prognosis of non-traumatic coma in African children.
With no date restrictions, systematic searches of MEDLINE, Embase, and Scopus will identify prospective and retrospective studies (including randomised controlled trials, cluster randomised trials, cohort studies, cross-sectional, and case-control studies) recruiting children (1 month-16 years) with non-traumatic coma (defined by Blantyre Coma Score ≤ 2 or comparable alternative) from any African country. Disease-specific studies will be included if coma is associated and reported. The primary outcome is to determine the aetiology (infectious and non-infectious) of non-traumatic coma in African children, with pooled prevalence estimates of causes (e.g., malaria). Secondary outcomes are to determine overall estimates of morbidity and mortality of all-cause non-traumatic coma and disease-specific states of non-traumatic coma, where available. Random effects meta-analysis will summarise aetiology data and in-hospital and post-discharge mortality. Heterogeneity will be quantified with τ, I, and Cochran's Q test.
This systematic review will provide a summary of the best available evidence on the aetiology and outcome of non-traumatic coma in African children.
PROSPERO CRD42020141937.
非创伤性昏迷是非洲医疗机构常见的急性儿童疾病，与高发病率和死亡率相关。历史上，大多数病例归因于脑疟疾（CM）。随着疟疾发病率的急剧下降，非疟疾性昏迷在病例中所占比例越来越大，确定病因具有诊断挑战性，尤其是在资源有限的环境中。本研究的目的是评估非洲儿童非创伤性昏迷的病因和预后。
无时间限制，对 MEDLINE、Embase 和 Scopus 进行系统检索，将确定前瞻性和回顾性研究（包括随机对照试验、整群随机试验、队列研究、横断面和病例对照研究），这些研究招募来自任何非洲国家的非创伤性昏迷（定义为 Blantyre 昏迷评分≤2 或类似替代评分）的儿童（1 个月至 16 岁）。如果昏迷与疾病相关且有报道，将纳入特定疾病的研究。主要结局是确定非创伤性昏迷的病因（感染性和非感染性），汇总病因（如疟疾）的患病率估计值。次要结局是确定所有原因非创伤性昏迷和非创伤性昏迷特定状态的总体发病率和死亡率（如有）。随机效应荟萃分析将总结病因数据以及住院期间和出院后的死亡率。采用τ、I 和 Cochran's Q 检验来量化异质性。
本系统评价将总结非洲儿童非创伤性昏迷病因和结局的最佳现有证据。
PROSPERO CRD42020141937。
