CSF Global, Dhaka 1213, Bangladesh.
Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1212, Bangladesh.
Nutrients. 2022 Mar 12;14(6):1211. doi: 10.3390/nu14061211.
Malnutrition is substantially higher among children with cerebral palsy (CP) in low- and middle-income countries (LMICs) when compared with the general population. Access to appropriate interventions is crucial for better management of malnutrition and nutritional outcomes of those children. We aimed to review the existing evidence on nutrition interventions for children with CP in LMICs.
Online databases, i.e., PubMed and Scopus, and Google Scholar were searched up to 10 January 2022, to identify peer-reviewed publications/evidence on LMIC focused nutritional management guidelines/interventions. Following title screening and abstract review, full articles that met the inclusion/exclusion criteria were retained for data charting. Information about the study characteristics, nutrition interventions, and their effectiveness were extracted. Descriptive data were reported.
Eight articles published between 2008 and 2019 were included with data from a total of = 252 children with CP (age range: 1 y 0 m-18 y 7 m, 42% female). Five studies followed experimental design; = 6 were conducted in hospital/clinic/center-based settings. Four studies focused on parental/caregiver training; = 2 studies had surgical interventions (i.e., gastrostomy) and = 1 provided neurodevelopmental therapy feeding intervention. Dietary modification as an intervention (or component) was reported in = 5 studies and had better effect on the nutritional outcomes of children with CP compared to interventions focused on feeding skills or other behavioral modifications. Surgical interventions improved nutritional outcomes in both studies; however, none documented any adverse consequences of the surgical interventions.
There is a substantial knowledge gap on nutrition interventions for children with CP in LMICs. This hinders the development of best practice guidelines for the nutritional management of children with CP in those settings. Findings suggest interventions directly related to growth/feeding of children had a better outcome than behavioral interventions. This should be considered in planning of nutrition-focused intervention or comprehensive services for children with CP in LMICs.
与普通人群相比，中低收入国家（LMICs）的脑瘫儿童（CP）营养不良发生率显著更高。获得适当的干预措施对于更好地管理营养不良和这些儿童的营养结果至关重要。我们旨在综述 LMICs 中针对 CP 儿童的营养干预措施的现有证据。
截至 2022 年 1 月 10 日，我们在在线数据库（即 PubMed 和 Scopus 以及 Google Scholar）中搜索了同行评审的出版物/证据，以确定针对 LMIC 集中的营养管理指南/干预措施的研究。经过标题筛选和摘要审查，符合纳入/排除标准的全文文章被保留用于数据图表。提取有关研究特征、营养干预措施及其有效性的信息。报告描述性数据。
共纳入 8 篇发表于 2008 年至 2019 年的文章，这些文章的数据来自于总共 252 名 CP 儿童（年龄范围：1 岁 0 个月至 18 岁 7 个月，42%为女性）。五项研究采用实验设计；6 项研究在医院/诊所/中心进行。四项研究侧重于父母/照顾者培训；两项研究有手术干预（即胃造口术），一项研究提供神经发育治疗喂养干预。有 5 项研究报告了饮食调整作为干预措施（或组成部分），与侧重于喂养技能或其他行为改变的干预措施相比，对 CP 儿童的营养结果有更好的效果。两项研究中的手术干预改善了营养结果；然而，没有任何研究记录手术干预的任何不良后果。
中低收入国家针对 CP 儿童的营养干预措施存在很大的知识差距。这阻碍了这些环境中 CP 儿童营养管理最佳实践指南的制定。研究结果表明，与儿童生长/喂养直接相关的干预措施比行为干预措施效果更好。在为中低收入国家的 CP 儿童规划以营养为重点的干预措施或综合服务时，应考虑这一点。
