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Systematic Reviews
Published in: Systematic Reviews 1/2016

Open Access 01-12-2016 | Protocol

The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: protocol for a systematic review and network meta-analysis

Authors: Ivan D. Florez, Reem Al-Khalifah, Javier M. Sierra, Claudia M. Granados, Juan J. Yepes-Nuñez, Carlos Cuello-Garcia, Giordano Perez-Gaxiola, Adriana M. Zea, Gilma N. Hernandez, Areti-Angeliki Veroniki, Gordon H. Guyatt, Lehana Thabane

Published in: Systematic Reviews | Issue 1/2016

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Abstract

Background

Acute diarrhea and acute gastroenteritis (AD/AGE) are common among children in low- and middle-income countries (LMIC) and high-income countries (HIC). Supportive therapy including maintaining feeding, prevention of dehydration, and use of oral rehydration solution (ORS), is the mainstay of treatment in all children. Several additional treatments aiming to reduce the episode duration have been compared to placebo, but the differences in effectiveness among them are unknown.

Methods and analysis

We will conduct a systematic review of all randomized controlled trials evaluating the use of zinc, vitamin A, probiotics, prebiotics, synbiotics, racecadotril, smectite, and fermented and lactose-free milk/formula for AD/AGE treatment in children. The primary outcomes are diarrhea duration and mortality. Secondary outcomes are diarrhea lasting 3 or 7 days, stool frequency, treatment failure, hospitalizations, and adverse events. We will search MEDLINE, Ovid EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS through Ovid, as well as grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information, and assess the risk of bias (ROB) and the confidence in the estimate (with the grading of recommendations, assessment, development, and evaluation [GRADE] approach). Results will be summarized narratively and statistically. Subgroup analysis according to HIC vs. LMIC, age, nutrition status, and ROB is planned. We will perform a Bayesian network meta-analysis to combine the pooled direct and indirect treatment effect estimates for each outcome, if adequate data is available.

Discussion

This is the first systematic review and network meta-analysis that aims to determine the relative effectiveness of pharmacological and nutritional treatments for reducing the duration of AD/AGE in children. The results will help to reduce the uncertainty of the effectiveness of the interventions, find knowledge gaps, and/or encourage further research for other therapeutic options.

Systematic review registration

PROSPERO registration number: CRD42015023778.​
Appendix
Available only for authorised users
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Metadata
Title
The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: protocol for a systematic review and network meta-analysis
Authors
Ivan D. Florez
Reem Al-Khalifah
Javier M. Sierra
Claudia M. Granados
Juan J. Yepes-Nuñez
Carlos Cuello-Garcia
Giordano Perez-Gaxiola
Adriana M. Zea
Gilma N. Hernandez
Areti-Angeliki Veroniki
Gordon H. Guyatt
Lehana Thabane
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2016
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-016-0186-8

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