社区环境中用于治疗严重急性营养不良的即食治疗食品的最佳铁含量：系统评价和荟萃分析的方案。

Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis.

机构信息

Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, SUNY Upstate Medical University, Syracuse, New York, USA

College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.

出版信息

BMJ Open. 2022 Mar 9;12(3):e057389. doi: 10.1136/bmjopen-2021-057389.

DOI:10.1136/bmjopen-2021-057389

PMID:35264366

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8915355/

Abstract

INTRODUCTION

The current standard of care for children with severe acute malnutrition (SAM) involves using ready-to-use therapeutic food (RUTF) to promote growth; however, the precise formulation to achieve optimal recovery remains unclear. Emerging research suggests that alternative RUTF formulations may be more effective in correcting SAM-related complications such as anaemia and iron deficiency. This systematic review commissioned by the WHO aims to synthesise the most recent research on the iron content in RUTF and related products in the community-based treatment of uncomplicated severe malnutrition in children aged 6 months and older.

METHODS AND ANALYSIS

We will search multiple electronic databases. We will include randomised controlled trials and non-randomised studies with a control arm. The intervention group will be infants who received RUTF treatments other than the current recommended guidelines set forth by the WHO. The comparison group is children receiving RUTF containing iron at the current WHO-recommended level of 1.9 mg/100 kcal (10-14 mg/100 g). The primary outcomes of interest include blood haemoglobin concentration, any anaemia, severe anaemia, iron-deficiency anaemia, recovery from SAM and any adverse outcomes. We will use meta-analysis to pool findings if sufficient homogeneity exists among included studies. The risk of bias in studies will be evaluated using the Cochrane risk of bias-2. We will use the Grading of Recommendations Assessment, Development, and Evaluation(GRADE) approach to examine the overall certainty of evidence.

ETHICS AND DISSEMINATION

This is a systematic review and will not involve direct contact with human subjects. The findings of this review will be published in a peer-reviewed journal and will guide the WHO's recommendation on the optimal iron content in RUTFs for the treatment of SAM in children aged 6-59 months.

摘要

简介

目前，治疗严重急性营养不良（SAM）儿童的标准治疗方法包括使用即食治疗食品（RUTF）来促进生长；然而，实现最佳恢复的确切配方仍不清楚。新出现的研究表明，替代 RUTF 配方可能更有效地纠正与 SAM 相关的并发症，如贫血和缺铁。本项由世界卫生组织委托进行的系统评价旨在综合最新研究，评估 RUTF 及相关产品中的铁含量，及其在社区治疗 6 个月及以上年龄的非复杂性严重营养不良儿童中的作用。

方法与分析

我们将搜索多个电子数据库。我们将纳入随机对照试验和非随机对照研究，且有对照组。干预组将是接受 RUTF 治疗而非世卫组织目前推荐的指南的婴儿。对照组为接受世卫组织目前推荐的铁含量（1.9mg/100kcal，10-14mg/100g）的 RUTF 的儿童。主要关注的结局包括血液血红蛋白浓度、任何贫血、严重贫血、缺铁性贫血、SAM 恢复和任何不良结局。如果纳入研究之间存在足够的同质性，我们将使用荟萃分析来汇总研究结果。将使用 Cochrane 偏倚风险-2 评估研究的偏倚风险。我们将使用推荐评估、制定与评价（GRADE）方法来评估证据的总体确定性。