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Okullo AE, John CC, Idro R, Conroy AL, Kinengyere AA, Ojiambo KO, Otike C, Ouma S, Ocan M, Obuku EA, van Hensbroek MB. Prevalence and risk factors of gross neurologic deficits in children after severe malaria: a systematic review protocol. Syst Rev 2025; 14:76. [PMID: 40181467 PMCID: PMC11967140 DOI: 10.1186/s13643-025-02785-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/07/2025] [Indexed: 04/05/2025] Open
Abstract
BACKGROUND Children exposed to severe malaria may recover with gross neurologic deficits (GND). Several risk factors for GND after cerebral malaria (CM), the deadliest form of severe malaria, have been identified in children. However, there is inconsistency between previously reported and more recent findings. Although CM patients are the most likely group to develop GND, it is not clear if other forms of severe malaria (non-CM) may also contribute to malaria-related GND. The objective of this systematic review is to synthesize evidence on the prevalence and risk factors for GND in children after severe malaria. METHODS The systematic review will be conducted according to recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P). Relevant research articles will be identified using relevant search terms from the following databases: MEDLINE, Embase, Web of Science, and Global Index Medicus (GIM). The articles will be screened at title and abstract and then at full text for inclusion using a priori eligibility criteria. Data extraction will be carried out using a tool developed and optimized in an Excel spreadsheet. Risk of bias will be assessed using appropriate tools including Risk Of Bias In Non-randomized Studies of Exposures (ROBINS-E) and the Cochrane Risk of Bias 2.0 (ROB2) for randomized control trials (RCTs), and where appropriate, publication bias will be assessed using a funnel plot. A random-effects meta-analysis or synthesis without meta-analysis (SWiM) will be performed as appropriate, and the results will be presented in tables and graphs. CONCLUSION Findings from this systematic review will inform policymakers on the planning, design, and implementation of interventions targeting the treatment and rehabilitation of GND following severe malaria in children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022297109.
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Affiliation(s)
- Allen Eva Okullo
- Department of Paediatrics, Amsterdam University Medical Centers, University of Amsterdam, P. O. Box 22660, Amsterdam, 1100 DD, The Netherlands.
- Global Health Uganda, Plot 667 Mawanda Road, P. O. Box 33842, Kampala, Uganda.
- Africa Center for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.
| | - Chandy C John
- Global Health Uganda, Plot 667 Mawanda Road, P. O. Box 33842, Kampala, Uganda
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 1044 W. Walnut Street, Rm 402D, Indianapolis, IN, 46202, USA
| | - Richard Idro
- Global Health Uganda, Plot 667 Mawanda Road, P. O. Box 33842, Kampala, Uganda
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Andrea L Conroy
- Global Health Uganda, Plot 667 Mawanda Road, P. O. Box 33842, Kampala, Uganda
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 1044 W. Walnut Street, Rm 402D, Indianapolis, IN, 46202, USA
| | - Alison Annet Kinengyere
- Africa Center for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
- Sir Albert Cook Library, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Kevin Ouma Ojiambo
- Africa Center for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Caroline Otike
- Africa Center for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
- Joint Clinical Research Centre, P. O. Box 10005, Kampala, Uganda
| | - Simple Ouma
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Moses Ocan
- Africa Center for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
- Department of Pharmacology & Therapeutics, School of Biomedical Sciences, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Ekwaro A Obuku
- Africa Center for Systematic Reviews & Knowledge Translation, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, WCETH11, Keppel Street, London, UK
| | - Michael Boele van Hensbroek
- Department of Paediatrics, Amsterdam University Medical Centers, University of Amsterdam, P. O. Box 22660, Amsterdam, 1100 DD, The Netherlands
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Okullo AE, John CC, Idro R, Conroy AL, Kinengyere AA, Ojiambo KO, Otike C, Ouma S, Ocan M, Obuku EA, van Hensbroek MB. Prevalence and risk factors of gross neurologic deficits in children after severe malaria: a systematic review protocol. RESEARCH SQUARE 2024:rs.3.rs-3374025. [PMID: 38464321 PMCID: PMC10925458 DOI: 10.21203/rs.3.rs-3374025/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Children exposed to severe malaria may recover with gross neurologic deficits (GND). Several risk factors for GND after cerebral malaria (CM), the deadliest form of severe malaria, have been identified in children. However, there is inconsistency between previously reported and more recent findings. Although CM patients are the most likely group to develop GND, it is not clear if other forms of severe malaria (non-CM) may also contribute to the malaria related GND. The aim of this systematic review is to synthesize evidence on the prevalence and risk factors for GND in children following CM and map the changes in patterns over time. In addition, this review will synthesize evidence on the reported prevalence and risk factors of gross neurologic deficits following other forms of severe malaria. Methods The systematic review will be conducted according to recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P). Relevant research articles will be identified using relevant search terms from the following databases: MEDLINE, Embase, Web of Science and Global Index Medicus (GIM). The articles will be screened at title and abstract, then at full text for inclusion using a priori eligibility criteria. Data extraction will be done using a tool developed and optimized in Excel spreadsheet. Risk of bias assessment will be done using appropriate tools including ROBINS-E ('Risk Of Bias In Non-randomized Studies of Exposure') tool, while publication bias will be assessed using funnel plot. A random-effects meta-analysis and structured narrative synthesis of the outcomes will be performed and results presented. Discussion Findings from this systematic review will inform policy makers on planning, design and implementation of interventions targeting the treatment and rehabilitation of GND following severe malaria in children. Systematic review registration The protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42022297109.
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Affiliation(s)
- Allen Eva Okullo
- University of Amsterdam Faculty of Medicine: Amsterdam UMC Locatie AMC
| | | | - Richard Idro
- Makerere University Faculty of Medicine: Makerere University College of Health Sciences
| | | | | | - Kevin Ouma Ojiambo
- Makerere University Faculty of Medicine: Makerere University College of Health Sciences
| | | | - Simple Ouma
- Makerere University Faculty of Medicine: Makerere University College of Health Sciences
| | - Moses Ocan
- Makerere University Faculty of Medicine: Makerere University College of Health Sciences
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