SynthesisBMJ global health2021
The impact of childhood malnutrition on mortality from pneumonia: a systematic review and network meta-analysis.
Synthesis in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Pooled it
- Effects of oral nutritional supplement on growth and body composition in malnutrition at risk and malnourished children: MARVEL study, a multi-center randomized controlled trial.European journal of nutrition · 2026Trial
- Effect of nutritional supplementation with lipid-based therapeutic food on body composition of non-severely malnourished African children aged 6-59 months hospitalized with severe pneumonia.Journal of tropical pediatrics · 2025Trial
- Targeted pneumococcal conjugate vaccination strategies for high-risk children.Human vaccines & immunotherapeutics · 2026Review
- Assessment of nutritional status of critically Ill pediatric patients and its impact on outcome in a low-and middle-income settings.European journal of pediatrics · 2026Observational
- Prenatal and postnatal household air pollution and longitudinal growth trajectories: results from long-term follow up of the GRAPHS cohort.Environment international · 2026Article
- Glucocorticoids intrinsically redirect naïve CD4+ T cells to the bone marrow for preservation in malnourished mice.Biology open · 2026Article
- Prognosis of clinical pneumonia in undernourished children in rural Gambia.Pneumonia (Nathan Qld.) · 2026Article
- External Validation of Pediatric Pneumonia and Bronchiolitis Risk Scores to Predict Mortality in Children Hospitalized in Kenya: A Retrospective Cohort Study.The Journal of infectious diseases · 2026Article
- Association between maternal employment and child stunting in Kenya.BMC public health · 2026Article
- Association between admission undernutrition and mortality rates and adverse outcomes in a pediatric intensive care unit in India: a prospective cohort study.Frontiers in pediatrics · 2026Article
- Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000-2023: a systematic analysis from the Global Burden of Disease Study 2023.The Lancet. Child & adolescent health · 2026Article
- Risk Factors and Predictors of Pneumonia Among Under-Five Children in Sana'a City, Yemen: A Multicenter Case-Control Study.Pediatric health, medicine and therapeutics · 2026Article
- Time to death and its predictors among under-five children with acute pneumonia: a Bayesian parametric survival analysis.Pneumonia (Nathan Qld.) · 2025Article
- The Burden of Hospitalization Due toHealth science reports · 2025Review
- Recovery Rate of Children From Pneumonia and Its Predictors in Ethiopia: A Systematic Review and Meta-Analysis.Health science reports · 2025Review
- Antimicrobial Usage Among Acutely Ill Hospitalized Children Aged 2‒23 Months in Sub-Saharan Africa and South Asia.Open forum infectious diseases · 2025Article
- Can Lung Ultrasound Act as a Diagnosis and Monitoring Tool in Children with Community Acquired Pneumonia? Correlation with Risk Factors, Clinical Indicators and Biologic Results.Journal of clinical medicine · 2025Article
- "A child with severe pneumonia cannot feed, causing malnutrition": exploring health worker and caregiver perspectives and practices for mitigating malnutrition among children with severe pneumonia, a case of Uganda.BMC health services research · 2025Article
- The ABCDs of Nutritional Assessment in Infectious Diseases Research.The Journal of infectious diseases · 2025Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionChildhood malnutrition is widespread in low-income and middle-income countries (LMICs) and increases the frequency and severity of infections such as pneumonia. We aimed to identify studies investigating pneumonia deaths in malnourished children and estimate mortality risk by malnutrition severity.
methodsWe conducted a systematic review of MEDLINE, EMBASE and Global Health databases to identify relevant studies. We used a network meta-analysis to derive ORs of death from pneumonia for moderately and severely underweight children using low weight-for-age, the most reported measure of malnutrition. We compared meta-estimates of studies conducted before and after 2000 to assess changes in mortality risk over time. We estimated the prevalence of underweight hospitalised children from hospital-based cohort studies and calculated the population attributable fraction of in-hospital pneumonia deaths from being underweight using our results.
resultsOur network meta-analysis included 33 544 underweight children from 23 studies. The estimated OR of death from pneumonia was 2.0 (95% CI 1.6 to 2.6) and 4.6 (95% CI 3.7 to 5.9) for children moderately and severely underweight, respectively. The OR of death from pneumonia for those severely underweight was 5.3 (95% CI 3.9 to 7.4) pre-2000 and remained high post-2000 at 4.1 (95% CI 3.0 to 6.0). Prevalence of underweight children hospitalised with pneumonia varied (median 40.2%, range 19.6-66.3) but was high across many LMIC settings. We estimated a median 18.3% (range 10.8-34.6) and 40.9% (range 14.7-69.9) of in-hospital pneumonia deaths were attributable to being moderately and severely underweight, respectively.
conclusionsThe risk of death from childhood pneumonia dramatically increases with malnutrition severity. This risk has remained high in recent years with an estimated over half of in-hospital pneumonia deaths attributable to child malnutrition. Prevention and treatment of all child malnutrition must be prioritised to maintain progress on reducing pneumonia deaths.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.