Efficacy of Probiotics in the Treatment of Acute Infectious Diarrhoeal Disease in African Children: A Protocol For Systematic Review and Meta-Analysis

Abstract

Background: Diarrhoeal disease is a major global health challenge, causing about 1.7 billion cases annually. It is a major contributor to childhood malnutrition, and mortality in children under five. 

Objective: To systematically evaluate the impact of probiotic therapy on diarrhoeal morbidity and mortality in African children between 2010 and 2022.

Methods: A search strategy was developed using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Researchgate and Scopus. Only randomised, double-blind, controlled trials retrievable in English will be included. The primary outcome will be the duration of acute diarrhoea in African children receiving probiotics. Secondary outcomes will include effects on fever, hospitalisation, vomiting, stool frequency/volume, and side effects. Studies will be screened, deduplicated, and eligible studies identified using DistillerSR. Methodological, clinical, and statistical heterogeneity will be assessed. Meta-bias will be evaluated using the Cochrane RoB 2 tool. Publication bias will be assessed using funnel plots and Egger's test. Pooled mean differences in diarrhoeal duration will be reported with standard error and 95% CI. Evidence strength will be rated using the GRADE approach.

Discussion: This study will evaluate the efficacy of probiotics in African children, reporting their effects on diarrhoeal duration, fever, hospital stay, vomiting, stool frequency and volume, and adverse effects. It will examine the moderating effects of sociodemographic factors and probiotic species. Findings will be published in peer-reviewed scientific journals.

Systematic Review Registration: This protocol has been registered with PROSPERO, registration number CRD42023416270