TY - JOUR
T1 - Improving outcomes for neonates with gastroschisis in low-income and middle- income countries: a systematic review protocol
AU - Wright, Naomi Jane
AU - Langer, Monica
AU - Norman, Irena
AU - Akhbari, Melika
AU - Wafford, Eileen
AU - Ade-Ajayi, Niyi
AU - Davies, Justine Ina
AU - Poenaru, Dan
AU - Sevdalis, Nick
AU - Leather, Andrew John Moffat
PY - 2018/12/27
Y1 - 2018/12/27
N2 - AbstrACt
Introduction There is a signi cant disparity in outcomes for neonates with gastroschisis in high-income countries (HICs) compared with low-income and middle-income countries (LMICs). Many LMICs report mortality rates between 75% and 100% compared with <4% in HICs. Aim To undertake a systematic review identifying postnatal interventions associated with improved outcomes for gastroschisis in LMICs.
Methods and analysis Three search strings will
be combined: (1) neonates; (2) gastroschisis and other gastrointestinal congenital anomalies requiring similar surgical care; (3) LMICs. Databases to be searched include MEDLINE, EMBASE, Scopus, Web of Science, ProQuest Dissertations and Thesis Global, and the Cochrane Library. Grey literature will be identi ed through Open-Grey, ClinicalTrials.gov, WHO International Clinical Trials Registry and ISRCTN registry (Springer Nature). Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two reviewers independently and team consensus sought on discrepancies. The primary outcome of interest is mortality. Secondary outcomes include complications, requirement for ventilation, parenteral nutrition duration and length of hospital stay. Tertiary outcomes include service delivery and implementation outcomes. The methodology of
the studies will be appraised. Descriptive statistics and outcomes will be summarised and discussed.
Ethics and dissemination Ethical approval is
not required since no new data are being collected. Dissemination will be via open access publication in a peer-reviewed medical journal and distribution among global health, global surgery and children’s surgical collaborations and international conferences.
Conclusion This study will systematically review literature focused on postnatal interventions to improve outcomes from gastroschisis in LMICs. Findings can be used to help inform quality improvement projects in low- resource settings for patients with gastroschisis. In the rst instance, results will be used to inform a Wellcome Trust- funded multicentre clinical interventional study aimed at improving outcomes for gastroschisis across sub-Saharan Africa.
PrOsPErO registration number CRD42018095349.
AB - AbstrACt
Introduction There is a signi cant disparity in outcomes for neonates with gastroschisis in high-income countries (HICs) compared with low-income and middle-income countries (LMICs). Many LMICs report mortality rates between 75% and 100% compared with <4% in HICs. Aim To undertake a systematic review identifying postnatal interventions associated with improved outcomes for gastroschisis in LMICs.
Methods and analysis Three search strings will
be combined: (1) neonates; (2) gastroschisis and other gastrointestinal congenital anomalies requiring similar surgical care; (3) LMICs. Databases to be searched include MEDLINE, EMBASE, Scopus, Web of Science, ProQuest Dissertations and Thesis Global, and the Cochrane Library. Grey literature will be identi ed through Open-Grey, ClinicalTrials.gov, WHO International Clinical Trials Registry and ISRCTN registry (Springer Nature). Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two reviewers independently and team consensus sought on discrepancies. The primary outcome of interest is mortality. Secondary outcomes include complications, requirement for ventilation, parenteral nutrition duration and length of hospital stay. Tertiary outcomes include service delivery and implementation outcomes. The methodology of
the studies will be appraised. Descriptive statistics and outcomes will be summarised and discussed.
Ethics and dissemination Ethical approval is
not required since no new data are being collected. Dissemination will be via open access publication in a peer-reviewed medical journal and distribution among global health, global surgery and children’s surgical collaborations and international conferences.
Conclusion This study will systematically review literature focused on postnatal interventions to improve outcomes from gastroschisis in LMICs. Findings can be used to help inform quality improvement projects in low- resource settings for patients with gastroschisis. In the rst instance, results will be used to inform a Wellcome Trust- funded multicentre clinical interventional study aimed at improving outcomes for gastroschisis across sub-Saharan Africa.
PrOsPErO registration number CRD42018095349.
U2 - 10.1136/ bmjpo-2018-000392
DO - 10.1136/ bmjpo-2018-000392
M3 - Article
SP - 1
EP - 7
JO - BMJ Paediatrics Open
JF - BMJ Paediatrics Open
ER -