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非洲先天性心脏病患儿营养不足的患病率及相关因素:一项系统评价和荟萃分析。

Prevalence of undernutrition and associated factors among children with congenital heart disease in Africa: a systemic review and meta-analysis.

作者信息

Akele Mequanint Ayehu, Dagnaw Tenagnework Eseyneh, Mehari Molla Getie, Delie Amare Mebrat, W/Tsadik Daniel Sisay, Mekonnen Migbar Sibhat, Tegegn Tamalew Alemie, Mihretie Dires Birhanu, Alem Kassa Genetu

机构信息

Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.

Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.

出版信息

J Transl Med. 2025 Apr 1;23(1):384. doi: 10.1186/s12967-024-05952-8.

Abstract

BACKGROUND

Undernutrition is a major public health issue in children with congenital heart disease in Africa. In this continent, the degree of undernutrition also varies from country to country. Therefore, summarizing data concerning undernutrition in children with congenital heart disease is essential to refine treatment guidelines and policies. This meta-analysis aims to deliver pooled data concerning undernutrition among African children with congenital heart disease.

METHODS

In this review, relevant studies were searched via PubMed/MEDLINE online, Science Direct, Hinari, Web of Science, CINHAL, EMBASE, WHO database, Google, and Google Scholar. To conduct this review, PRISMA guidelines were used. STATA 17 was used to estimate the pooled prevalence of undernutrition in children. A random effect meta-analysis model was used to conduct this meta-analysis. The heterogeneity of the studies was evaluated by the I2 test. Publication bias was assessed via funnel plots supplemented with Egger's weighted regression test. Finally, for all analyses, p < 0.05 was considered statistically significant.

RESULT

In this review, a total of 5898 studies were found. Among these, 5878 were excluded using PRISMA, and the remaining 20 studies were included in the final analysis. The prevalence of undernutrition, underweight, wasting, and stunting in children with congenital heart disease was 65.14% (95% CI 51.32-78.95, I = 97.4%, p = 0.0001), 45.76% (95% CI 35.83-55.69, I = 96.7, p < 0.0001), 39.37% (95% CI 29.55-49.19, I = 97.4, p < 0.0001), and 39.38% (95% CI 33.02-45.72, I = 92.4%, p < 0.0001), respectively. Anemia (OR = 4.5, 95% CI 1.60-12.68), CHF (OR = 5.98, 95% CI 3.09-11.57), pulmonary hypertension (OR = 2.76, 95% CI 1.89-4.04), and age (OR = 2.78, 95% CI 1.79-4.31) were associated with undernutrition in children with CHD.

CONCLUSION

In this meta-analysis, the pooled prevalence of undernutrition and its indicators in children with CHD were high. As a result, there is still a need to improve early screening and treatment of undernutrition in children with congenital heart disease concomitant with early screening and treatment of congenital heart disease and its common complications in Africa.

摘要

背景

营养不良是非洲先天性心脏病患儿面临的一个主要公共卫生问题。在这个大陆上,营养不良的程度在不同国家也有所不同。因此,总结先天性心脏病患儿营养不良的数据对于完善治疗指南和政策至关重要。本荟萃分析旨在提供有关非洲先天性心脏病患儿营养不良的汇总数据。

方法

在本综述中,通过PubMed/MEDLINE在线数据库、Science Direct、Hinari、Web of Science、CINHAL、EMBASE、世界卫生组织数据库、谷歌及谷歌学术搜索相关研究。为进行本综述,采用了PRISMA指南。使用STATA 17估计儿童营养不良的合并患病率。采用随机效应荟萃分析模型进行此荟萃分析。通过I²检验评估研究的异质性。通过漏斗图并辅以Egger加权回归检验评估发表偏倚。最后,对于所有分析,p < 0.05被认为具有统计学意义。

结果

在本综述中,共找到5898项研究。其中,根据PRISMA排除了5878项,其余20项研究纳入最终分析。先天性心脏病患儿营养不良、体重不足、消瘦和发育迟缓的患病率分别为65.14%(95%CI 51.32 - 78.95,I = 97.4%,p = 0.0001)、45.76%(95%CI 35.83 - 55.69,I = 96.7,p < 0.0001)、39.37%(95%CI 29.55 - 49.19,I = 97.4,p < 0.0001)和39.38%(95%CI 33.02 - 45.72,I = 92.4%,p < 0.0001)。贫血(OR = 4.5,95%CI 1.60 - 12.68)、充血性心力衰竭(OR = 5.98,95%CI 3.09 - 11.57)、肺动脉高压(OR = 2.76,95%CI 1.89 - 4.04)和年龄(OR = 2.78,95%CI 1.79 - 4.31)与先天性心脏病患儿的营养不良有关。

结论

在本荟萃分析中,先天性心脏病患儿营养不良及其指标的合并患病率较高。因此,在非洲仍有必要改善先天性心脏病患儿营养不良的早期筛查和治疗,同时对先天性心脏病及其常见并发症进行早期筛查和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b080/11959727/278e0b061613/12967_2024_5952_Fig1_HTML.jpg

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