Breastfeeding for reducing the risk of pneumonia morbidity and mortality in children under two: a systematic literature review and meta-analysis.
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ABSTRACT:
SUBMITTER: Lamberti LM
PROVIDER: S-EPMC3847465 | biostudies-other | 2013
REPOSITORIES: biostudies-other
Publications
Breastfeeding for reducing the risk of pneumonia morbidity and mortality in children under two: a systematic literature review and meta-analysis.
Lamberti Laura M LM Zakarija-Grković Irena I Fischer Walker Christa L CL Theodoratou Evropi E Nair Harish H Campbell Harry H Black Robert E RE
BMC public health 20130917
<h4>Background</h4>Suboptimal breastfeeding practices among infants and young children <24 months of age are associated with elevated risk of pneumonia morbidity and mortality. We conducted a systematic review and meta-analysis to quantify the protective effects of breastfeeding exposure against pneumonia incidence, prevalence, hospitalizations and mortality.<h4>Methods</h4>We conducted a systematic literature review of studies assessing the risk of selected pneumonia morbidity and mortality out ...[more]
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Project description:BACKGROUND: Early breastfeeding is defined as the initiation of breastfeeding within twenty four hours of birth. While the benefits of breastfeeding have been known for decades, only recently has the role of time to initiation of breastfeeding in neonatal mortality and morbidity been assessed. OBJECTIVE: To review the evidence for early breastfeeding initiation practices and to estimate the association between timing and neonatal outcomes. METHODS: We systematically reviewed multiple databases from 1963 to 2011. Standardized abstraction tables were used and quality was assessed for each study utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Three meta-analyses were conducted for mortality among babies surviving to 48 hours. RESULTS: We identified 18 studies reporting a direct association between early breastfeeding initiation and neonatal mortality and morbidity outcomes. The results of random effects analyses of data from 3 studies (from 5 publications) demonstrated lower risks of all-cause neonatal mortality among all live births (RR = 0.56 [95% CI: 0.40 - 0.79]) and among low birth weight babies (RR=0.58 [95% CI: 0.43 - 0.78]), and infection-related neonatal mortality (RR = 0.55 [95% CI: 0.36 - 0.84]). Among exclusively breastfed infants, all-cause mortality risk did not differ between early and late initiators (RR = 0.69 [95% CI: 0.27 - 1.75]). CONCLUSIONS: This review demonstrates that early breastfeeding initiation is a simple intervention that has the potential to significantly improve neonatal outcomes and should be universally recommended. Significant gaps in knowledge are highlighted, revealing a need to prioritize additional high quality studies that further clarify the specific cause of death, as well as providing improved understanding of the independent or combined effects of early initiation and breastfeeding patterns.
| S-EPMC3847227 | biostudies-other
Project description:BACKGROUND: Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. METHODS: We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. RESULTS: We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52) and to any breastfeeding among children aged 6-23 months (RR: 2.18). CONCLUSIONS: Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.
| S-EPMC3231888 | biostudies-other
Project description:ObjectivesTo quantify the benefits and harms of general health checks in adults with an emphasis on patient-relevant outcomes such as morbidity and mortality rather than on surrogate outcomes.DesignCochrane systematic review and meta-analysis of randomised trials. For mortality, we analysed the results with random effects meta-analysis, and for other outcomes we did a qualitative synthesis as meta-analysis was not feasible.Data sourcesMedline, EMBASE, Healthstar, Cochrane Library, Cochrane Central Register of Controlled Trials, CINAHL, EPOC register, ClinicalTrials.gov, and WHO ICTRP, supplemented by manual searches of reference lists of included studies, citation tracking (Web of Knowledge), and contacts with trialists.Selection criteriaRandomised trials comparing health checks with no health checks in adult populations unselected for disease or risk factors. Health checks defined as screening general populations for more than one disease or risk factor in more than one organ system. We did not include geriatric trials.Data extractionTwo observers independently assessed eligibility, extracted data, and assessed the risk of bias. We contacted authors for additional outcomes or trial details when necessary.ResultsWe identified 16 trials, 14 of which had available outcome data (182,880 participants). Nine trials provided data on total mortality (11,940 deaths), and they gave a risk ratio of 0.99 (95% confidence interval 0.95 to 1.03). Eight trials provided data on cardiovascular mortality (4567 deaths), risk ratio 1.03 (0.91 to 1.17), and eight on cancer mortality (3663 deaths), risk ratio 1.01 (0.92 to 1.12). Subgroup and sensitivity analyses did not alter these findings. We did not find beneficial effects of general health checks on morbidity, hospitalisation, disability, worry, additional physician visits, or absence from work, but not all trials reported on these outcomes. One trial found that health checks led to a 20% increase in the total number of new diagnoses per participant over six years compared with the control group and an increased number of people with self reported chronic conditions, and one trial found an increased prevalence of hypertension and hypercholesterolaemia. Two out of four trials found an increased use of antihypertensives. Two out of four trials found small beneficial effects on self reported health, which could be due to bias.ConclusionsGeneral health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although they increased the number of new diagnoses. Important harmful outcomes were often not studied or reported.Systematic review registrationCochrane Library, doi:10.1002/14651858.CD009009.
| S-EPMC3502745 | biostudies-literature
Project description:ObjectivesThe objective of this study was to systematically review the mortality and morbidity associated with scleroderma renal crisis and to determine temporal trends.MethodsWe searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews from database inception to 10 February 2020. Bibliographies of selected articles were hand-searched for additional references. Data were extracted using a standardized extraction form. Study quality was assessed using the Newcastle-Ottawa scale. Results were analysed qualitatively.ResultsTwenty studies with 14,059 systemic sclerosis subjects, of which 854 had scleroderma renal crisis and 4095 had systemic sclerosis-associated end-stage renal disease, met inclusion criteria. Study quality was generally moderate. Cumulative mortality in the post-angiotensin-converting enzyme inhibitor era was approximately 20% at 6 months, 30%-36% at 1 year, 19%-40% at 3 years and almost 50% at 10 years from scleroderma renal crisis onset. Although the introduction of angiotensin-converting enzyme inhibitors in the early 1970s resulted in a 50% improvement in scleroderma renal crisis mortality, there was no further improvement thereafter. Scleroderma renal crisis mortality rates were proportionally higher than mortality rates associated with other systemic sclerosis organ involvement. The rate of permanent dialysis after scleroderma renal crisis in the post-angiotensin-converting enzyme inhibitor era ranged from 19%-40%. Three to 17% of systemic sclerosis patients underwent renal transplant. Survival was better in patients post-renal transplant (54%-91%) compared to those on dialysis (31%-56%). Graft survival improved over time and appeared similar to that of patients with other types of end-stage renal disease.ConclusionWhile there has been considerable improvement in scleroderma renal crisis-related outcomes since the introduction of angiotensin-converting enzyme inhibitors, morbidity and mortality remain high for affected patients without convincing evidence of further improvement in the post-angiotensin-converting enzyme inhibitor era. Novel treatments are required to improve outcomes of scleroderma renal crisis.
| S-EPMC8922629 | biostudies-literature
Project description:The global burden of cardiovascular mortality is increasing, as is the number of large-scale humanitarian emergencies. The interaction between these phenomena is not well understood. This review aims to clarify the relationship between humanitarian emergencies and cardiovascular morbidity and mortality.With assistance from a research librarian, electronic databases (PubMed, Scopus, CINAHL, and Global Health) were searched in January 2014. Findings were supplemented by reviewing citations of included trials. Observational studies reporting the effect of natural disasters and conflict events on cardiovascular morbidity and mortality in adults since 1997 were included. Studies without a comparison group were not included. Double-data extraction was utilized to abstract information on acute coronary syndrome (ACS), acute decompensated heart failure (ADHF), and sudden cardiac death (SCD). Review Manager 5.0 (Version 5.2, The Nordic Cochrane Centre; Copenhagen Denmark,) was used to create figures for qualitative synthesis.The search retrieved 1,697 unique records; 24 studies were included (17 studies of natural disasters and seven studies of conflict). These studies involved 14,583 cardiac events. All studies utilized retrospective designs: four were population-based, 15 were single-center, and five were multicenter studies. Twenty-three studies utilized historical controls in the primary analysis, and one utilized primarily geographical controls.Conflicts are associated with an increase in long-term morbidity from ACS; the short-term effects of conflict vary by study. Natural disasters exhibit heterogeneous effects, including increased occurrence of ACS, ADHF, and SCD.In certain settings, humanitarian emergencies are associated with increased cardiac morbidity and mortality that may persist for years following the event. Humanitarian aid organizations should consider morbidity from noncommunicable disease when planning relief and recuperation projects.
| S-EPMC4736140 | biostudies-literature
Project description:BACKGROUND: Few European countries conduct reactive surveillance of influenza mortality, whereas most monitor morbidity. METHODOLOGY/PRINCIPAL FINDINGS: We developed a simple model based on Poisson seasonal regression to predict excess cases of pneumonia and influenza mortality during influenza epidemics, based on influenza morbidity data and the dominant types/subtypes of circulating viruses. Epidemics were classified in three levels of mortality burden ("high", "moderate" and "low"). The model was fitted on 14 influenza seasons and was validated on six subsequent influenza seasons. Five out of the six seasons in the validation set were correctly classified. The average absolute difference between observed and predicted mortality was 2.8 per 100,000 (18% of the average excess mortality) and Spearman's rank correlation coefficient was 0.89 (P = 0.05). CONCLUSIONS/SIGNIFICANCE: The method described here can be used to estimate the influenza mortality burden in countries where specific pneumonia and influenza mortality surveillance data are not available.
| S-EPMC1866180 | biostudies-literature
Project description:Background:Pneumonia is currently the leading cause of morbidity and mortality among under-five children in developing countries, including Ethiopia. Although these problems are easily preventable and treatable, it contributes to more than 18% of deaths of under-five children every year in Ethiopia. Regardless of these facts, there is a paucity of information regarding the magnitude and its predictors of pneumonia in Ethiopia. Therefore, the main objective of this review is to determine the pooled magnitude of pneumonia and its predictors among under-five children in Ethiopia. Methods:The international databases such as MEDLINE/PubMed, EMBASE, Google Scholar, and Science Direct were scientifically explored. Articles were also searched by examining the gray literature on institutional databases and by reviewing reference lists of already identified articles. We considered all primary studies reporting the magnitude of pneumonia among under-five children and its predictors in Ethiopia. We retrieved all necessary data by using a standardized data extraction format spreadsheet. STATA 14 statistical software was used to analyze the data, and Cochrane's Q test statistics and I 2 test were used to assess the heterogeneity between the studies. Significant variability was found between the studies in such a way that a random-effect model was used. Result:The pooled magnitude of pneumonia among under-five children was 20.68% (I 2?=?97.9%; P ? 0.001) out of 12 studies in Ethiopia. Children who have unvaccinated (OR?=?2.45), food cooking in the main house (OR?=?2.46), vitamin A supplementation status (OR?=?2.85), malnutrition (OR?=?2.98), mixed breastfeeding (OR?=?2.46), and child history of respiratory tract infection (OR?=?4.11) were potential determinates of pneumonia. Conclusion and Recommendations. This review showed that the magnitude of pneumonia was relatively high. Hence, appropriate intervention on potential determinates such as health education on exclusive breastfeeding and nutrition, place of food cooking, increased immunization and vitamin A supplementation, and early control of respiratory tract infection was recommended to prevent those risk factors.
| S-EPMC7277048 | biostudies-literature
Project description:BACKGROUND:Acute diarrhea accounts for a huge burden of infectious diseases in under-five children. OBJECTIVE:This systematic review was carried out to study the prevalence and associated risk factors of diarrhea among Indian children aged <5 years. METHODS:Papers were identified by a comprehensive electronic search of relevant medical subject heading (MeSH) terms in PubMed. Identified articles were independently reviewed against inclusion/exclusion criteria and rated for quality. 15 articles were abstracted and reviewed to identify the reported prevalence and risk factors for childhood diarrhea. Meta-analysis was done for calculating the pooled prevalence of diarrhea and point estimates of risk factors using random effects model with use of appropriate population weights, and depicted using forest plot. RESULTS:The overall prevalence of diarrhea between 2002 and 2013 was 21.70% (95% confidence interval [CI]: 11.24-34.46). The significantly associated risk factors were malnutrition (odds ratio [OR]: 1.73, 95% CI: 1.53-1.96) and anemia (OR: 1.71, 95% CI: 1.29-2.28) in child, and low socioeconomic status (OR: 7.14, 95% CI: 2.19-23.32). Age of the child <24 months, not breastfeeding, mothers' low literacy status and untreated drinking water did not show a significant association. Sex of the child, religion, higher education of mothers, and seasonality were found to be inconsistently associated in single studies. CONCLUSION:It was concluded that there is sufficient evidence on the association of childhood diarrhea with socio-demographic factors, but evidence on other contributory factors including breastfeeding and vaccination is inconclusive. There is need to conduct more analytical studies on lesser known risk factors of diarrhea to establish their risk factors in Indian children.
| S-EPMC4764679 | biostudies-literature
Project description:BackgroundGlobal child mortality reduced substantially during the Millennium Development Goal period (2000-15). We aimed to estimate morbidity, mortality, and prevalence of risk factors for child pneumonia at the global, regional, and national level for developing countries for the Millennium Development Goal period.MethodsWe estimated the incidence, number of hospital admissions, and in-hospital mortality due to all-cause clinical pneumonia in children younger than 5 years in developing countries at 5-year intervals during the Millennium Development Goal period (2000-15) using data from a systematic review and Poisson regression. We estimated the incidence and number of cases of clinical pneumonia, and the pneumonia burden attributable to HIV for 132 developing countries using a risk-factor-based model that used Demographic and Health Survey data on prevalence of the various risk factors for child pneumonia. We also estimated pneumonia mortality in young children using data from multicause models based on vital registration and verbal autopsy.FindingsGlobally, the number of episodes of clinical pneumonia in young children decreased by 22% from 178 million (95% uncertainty interval [UI] 110-289) in 2000 to 138 million (86-226) in 2015. In 2015, India, Nigeria, Indonesia, Pakistan, and China contributed to more than 54% of all global pneumonia cases, with 32% of the global burden from India alone. Between 2000 and 2015, the burden of clinical pneumonia attributable to HIV decreased by 45%. Between 2000 and 2015, global hospital admissions for child pneumonia increased by 2·9 times with a more rapid increase observed in the WHO South-East Asia Region than the African Region. Pneumonia deaths in this age group decreased from 1·7 million (95% UI 1·7-2·0) in 2000 to 0·9 million (0·8-1·1) in 2015. In 2015, 49% of global pneumonia deaths occurred in India, Nigeria, Pakistan, Democratic Republic of the Congo, and Ethiopia collectively. All key risk factors for child pneumonia (non-exclusive breastfeeding, crowding, malnutrition, indoor air pollution, incomplete immunisation, and paediatric HIV), with the exception of low birthweight, decreased across all regions between 2000 and 2015.InterpretationGlobally, the incidence of child pneumonia decreased by 30% and mortality decreased by 51% during the Millennium Development Goal period. These reductions are consistent with the decrease in the prevalence of some of the key risk factors for pneumonia, increasing socioeconomic development and preventive interventions, improved access to care, and quality of care in hospitals. However, intersectoral action is required to improve socioeconomic conditions and increase coverage of interventions targeting risk factors for child pneumonia to accelerate decline in pneumonia mortality and achieve the Sustainable Development Goals for health by 2030.FundingBill & Melinda Gates Foundation.
| S-EPMC6293057 | biostudies-literature
Project description:ObjectiveTo assess the effectiveness of seasonal malaria chemoprevention (SMC) in reducing under-five malaria morbidity and mortality.DesignUnder-five malaria data for confirmed episodes, deaths, and number of children dosed per cycle of SMC campaign were extracted from the District Health Information Management System (DHIMS-2) for 2018-2019. Data verification was done to compare extracted data with the source for completeness and consistency. Association between SMC and the main outcome variables (malaria cases and mortality) was computed from 2X2 tables and reported as rate ratios at a 95% confidence level.SettingAll seven (7) districts in Savannah Region, Ghana.ParticipantsChildren under five years.InterventionSulphadoxine-Pyrimethamine and Amodiaquine (SPAQ) prophylaxis given monthly, four times, durng the rainy season (July to October).Main outcome measuresSMC coverage per cycle and under-five malaria morbidity and mortality ratios.ResultsOver 370,000 dose packs of SPAQ were administered with an average cycle coverage of 93%. There was approximately 17% (p<0.01) and 67% (p=0.047) reduction in malaria-related morbidity and mortality, respectively, in the implementation year compared with the baseline. This translated into nearly 9,300 episodes of all forms of malaria and nine malaria-attributable deaths averted by the intervention.ConclusionSMC (combined with existing control measures) wields prospects of accelerating the regional/national malaria elimination efforts if the implementation is optimised. Expansion of the intervention to other high-prevalence regions with seasonal variation in disease burden may be worthwhile.FundingNone declared.
| S-EPMC10336463 | biostudies-literature