Aetiology and outcome of non-traumatic coma in African children: protocol for a systematic review and meta-analysis

Ray, Stephen T. J., Fuller, Charlotte, Boubour, Alexandra, Bonnett, Laura J., Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Seydel, Karl B. and Griffiths, Michael J. (2021) 'Aetiology and outcome of non-traumatic coma in African children: protocol for a systematic review and meta-analysis'. Systematic Reviews, Vol 10, Issue 282.

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Abstract

Background
Non-traumatic coma is a common acute childhood presentation to healthcare facilities in Africa and is associated with high morbidity and mortality. Historically, the majority of cases were attributed to cerebral malaria (CM). With the recent drastic reduction in malaria incidence, non-malarial coma is becoming a larger proportion of cases and determining the aetiology is diagnostically challenging, particularly in resource-limited settings. The purpose of this study will be to evaluate the aetiology and prognosis of non-traumatic coma in African children.

Methods
With no date restrictions, systematic searches of MEDLINE, Embase, and Scopus will identify prospective and retrospective studies (including randomised controlled trials, cluster randomised trials, cohort studies, cross-sectional, and case-control studies) recruiting children (1 month–16 years) with non-traumatic coma (defined by Blantyre Coma Score ≤ 2 or comparable alternative) from any African country. Disease-specific studies will be included if coma is associated and reported. The primary outcome is to determine the aetiology (infectious and non-infectious) of non-traumatic coma in African children, with pooled prevalence estimates of causes (e.g., malaria). Secondary outcomes are to determine overall estimates of morbidity and mortality of all-cause non-traumatic coma and disease-specific states of non-traumatic coma, where available. Random effects meta-analysis will summarise aetiology data and in-hospital and post-discharge mortality. Heterogeneity will be quantified with τ2, I2, and Cochran’s Q test.

Discussion
This systematic review will provide a summary of the best available evidence on the aetiology and outcome of non-traumatic coma in African children.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods WB Practice of Medicine > WB 102 Clinical medicine WB Practice of Medicine > Diagnosis > General Diagnosis > WB 143 Signs and symptoms WS Pediatrics > WS 100 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s13643-021-01796-1
Depositing User:	Debbie Jenkins
Date Deposited:	05 Nov 2021 15:10
Last Modified:	05 Nov 2021 15:10
URI:	https://archive.lstmed.ac.uk/id/eprint/19351

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