Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis
Introduction The current standard of care for children with severe acute malnutrition (SAM) involves using ready-to-use therapeutic food (RUTF) to promote growth; however, the precise formulation to achieve optimal recovery remains unclear. Emerging research suggests that alternative RUTF formulatio...
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BMJ Publishing Group
2022-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/3/e057389.full |
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| author | Jai K Das Zulfiqar Ahmed Bhutta Abigail Smith Aamer Imdad Olivia Tsistinas Emily Tanner-Smith Melissa François Fanny F Chen |
| author_facet | Jai K Das Zulfiqar Ahmed Bhutta Abigail Smith Aamer Imdad Olivia Tsistinas Emily Tanner-Smith Melissa François Fanny F Chen |
| author_sort | Jai K Das |
| collection | DOAJ |
| description | Introduction The current standard of care for children with severe acute malnutrition (SAM) involves using ready-to-use therapeutic food (RUTF) to promote growth; however, the precise formulation to achieve optimal recovery remains unclear. Emerging research suggests that alternative RUTF formulations may be more effective in correcting SAM-related complications such as anaemia and iron deficiency. This systematic review commissioned by the WHO aims to synthesise the most recent research on the iron content in RUTF and related products in the community-based treatment of uncomplicated severe malnutrition in children aged 6 months and older.Methods and analysis We will search multiple electronic databases. We will include randomised controlled trials and non-randomised studies with a control arm. The intervention group will be infants who received RUTF treatments other than the current recommended guidelines set forth by the WHO. The comparison group is children receiving RUTF containing iron at the current WHO-recommended level of 1.9 mg/100 kcal (10–14 mg/100 g). The primary outcomes of interest include blood haemoglobin concentration, any anaemia, severe anaemia, iron-deficiency anaemia, recovery from SAM and any adverse outcomes. We will use meta-analysis to pool findings if sufficient homogeneity exists among included studies. The risk of bias in studies will be evaluated using the Cochrane risk of bias-2. We will use the Grading of Recommendations Assessment, Development, and Evaluation(GRADE) approach to examine the overall certainty of evidence.Ethics and dissemination This is a systematic review and will not involve direct contact with human subjects. The findings of this review will be published in a peer-reviewed journal and will guide the WHO’s recommendation on the optimal iron content in RUTFs for the treatment of SAM in children aged 6–59 months. |
| format | Article |
| id | doaj-art-b2173d4da55c47bda271a0e9b9a79b79 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b2173d4da55c47bda271a0e9b9a79b792025-08-20T01:48:02ZengBMJ Publishing GroupBMJ Open2044-60552022-03-0112310.1136/bmjopen-2021-057389Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysisJai K Das0Zulfiqar Ahmed Bhutta1Abigail Smith2Aamer Imdad3Olivia Tsistinas4Emily Tanner-Smith5Melissa François6Fanny F Chen79 Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan2 Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaLibrary Sciences, SUNY Upstate Medical University, Syracuse, New York, USA6 Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, University of Iowa Health Care, Stead Family Department of Pediatrics, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USAHealth Science Library, SUNY Upstate Medical University, Syracuse, New York, USACollege of Education, University of Oregon, Eugene, Oregon, USANorton College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USANorton College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USAIntroduction The current standard of care for children with severe acute malnutrition (SAM) involves using ready-to-use therapeutic food (RUTF) to promote growth; however, the precise formulation to achieve optimal recovery remains unclear. Emerging research suggests that alternative RUTF formulations may be more effective in correcting SAM-related complications such as anaemia and iron deficiency. This systematic review commissioned by the WHO aims to synthesise the most recent research on the iron content in RUTF and related products in the community-based treatment of uncomplicated severe malnutrition in children aged 6 months and older.Methods and analysis We will search multiple electronic databases. We will include randomised controlled trials and non-randomised studies with a control arm. The intervention group will be infants who received RUTF treatments other than the current recommended guidelines set forth by the WHO. The comparison group is children receiving RUTF containing iron at the current WHO-recommended level of 1.9 mg/100 kcal (10–14 mg/100 g). The primary outcomes of interest include blood haemoglobin concentration, any anaemia, severe anaemia, iron-deficiency anaemia, recovery from SAM and any adverse outcomes. We will use meta-analysis to pool findings if sufficient homogeneity exists among included studies. The risk of bias in studies will be evaluated using the Cochrane risk of bias-2. We will use the Grading of Recommendations Assessment, Development, and Evaluation(GRADE) approach to examine the overall certainty of evidence.Ethics and dissemination This is a systematic review and will not involve direct contact with human subjects. The findings of this review will be published in a peer-reviewed journal and will guide the WHO’s recommendation on the optimal iron content in RUTFs for the treatment of SAM in children aged 6–59 months.https://bmjopen.bmj.com/content/12/3/e057389.full |
| spellingShingle | Jai K Das Zulfiqar Ahmed Bhutta Abigail Smith Aamer Imdad Olivia Tsistinas Emily Tanner-Smith Melissa François Fanny F Chen Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis BMJ Open |
| title | Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis |
| title_full | Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis |
| title_fullStr | Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis |
| title_full_unstemmed | Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis |
| title_short | Optimal iron content in ready-to-use therapeutic foods for the treatment of severe acute malnutrition in the community settings: a protocol for the systematic review and meta-analysis |
| title_sort | optimal iron content in ready to use therapeutic foods for the treatment of severe acute malnutrition in the community settings a protocol for the systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/12/3/e057389.full |
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