SynthesisBMJ open2025
Mortality among children aged 28 days-17 years with pneumonia who are not severely undernourished and the effect of macronutrient supplementation: a systematic review and meta-analysis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePneumonia is associated with four times higher odds of death among children with severe undernutrition. However, there is an equipoise for the mortality of children without severe undernutrition and the impact of macronutrient interventions. We collated evidence on mortality, anthropometric outcomes and the effect of macronutrient interventions in the management of non-severely undernourished children (28 days-17 years) with pneumonia globally.
designSystematic review and meta-analysis using a priori criteria developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. DATA SOURCES: PubMed, Medline, EMBASE, Web of Science, Google Scholar, Scopus, Cochrane Central and bibliographies were searched between January 2000 and July 2024. ELIGIBILITY CRITERIA: We included articles conducted among children between 28 days and 17 years with pneumonia and non-severe malnutrition that reported on mortality and changes in anthropometric status or macronutrient supplementation. Studies conducted exclusively among adults, on micronutrient supplementation, case studies, commentaries and reviews were excluded. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened, abstracted the data and conducted risk of bias (RoB) using standard criteria including the RoB in non-randomised follow-up studies of exposure for observational studies and the revised Cochrane RoB assessment tool for randomised studies (RoB 2.0). Heterogeneity was assessed using the I
resultsA total of 15 articles were included (11 conducted in sub-Saharan Africa and four in Asia), with 169 901 participants overall. The mortality among non-severely undernourished children with pneumonia was 3.0% (95% CI 2% to 5%, I
conclusionsMortality among non-severely undernourished children with pneumonia ranges between 1-13% globally. There is inadequate follow-up nutritional assessment and management for non-severely undernourished children with pneumonia. PROSPERO REGISTRATION NUMBER: CRD42021257272.
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