Belachew, Tefera

De Boevre, Marthe

Hadush, Kokeb Tesfamariam

Kolsteren, Patrick

Lachat, Carl

Ghent University Academic Bibliography

21/02/2018 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046 1/4PROSPERO International prospective register of systematic reviewsDietary mycotoxins exposure and child growth, immune system, morbidity andmortality: protocol for a systematic literature reviewKokeb Tesfamariam, Marthe De Boevre, Tefera Belachew, Patrick Kolsteren, Carl LachatCitationKokeb Tesfamariam, Marthe De Boevre, Tefera Belachew, Patrick Kolsteren, Carl Lachat. Dietarymycotoxins exposure and child growth, immune system, morbidity and mortality: protocol for a systematicliterature review. PROSPERO 2018 CRD42018082046 Available from:http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018082046Review questionTypes of participants: this review will include children aged 5 years or younger.Types of exposure: mycotoxin exposure during pregnancy, lactation and childhood. Concentrations ofmycotoxin in the diet, breast milk, urine and blood will be taken into account.This review will consider studies that include the following outcome measures:• Child growth as measured by anthropometric measurements, such as weight for length/height, weight forage, length/height for age, mid-upper arm circumference (MUAC) and head circumference.• Morbidity: hepatic, gastrointestinal and respiratory diseases. Marasmus, kwashiorkor and marasmic-kwashiorkor.• Deaths occurring for children under ﬁve years of age: Perinatal mortality, neonatal mortality, infant mortalityand child mortality.• Studies on immune system of under-ﬁves.Setting There will be no restrictions by type of setting.SearchesThe databases to be searched will include: MEDLINE, EMBASE, Cochrane Library, CINAHL, Web ofScience, PsycINFO, grey literature through Google Scholar and reference lists to the papers reviewed. Studies published in English and French will be considered for inclusion in this review. There will be no daterestriction. The full search strategy in PubMed included MeSH-terms and text words. The search strategy will beadapted as required for other electronic databases.  Types of study to be includedThis review will consider both experimental and observational study designs including randomized controlledtrials, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospectiveand retrospective cohort studies, case control studies and analytical cross-sectional studies.Condition or domain being studiedMycotoxins, child growth, morbidity and mortality. Participants/populationThis review will include children aged 5 years or younger. Animal studies, drug trials, diagnostic trials and case reports will be excluded from the study review. Studiesonly reporting qualitative results will not be retained.Intervention(s), exposure(s)21/02/2018 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046 2/4Many important agricultural products, especially those rich in carbohydrates, are attractive colonization sitesfor fungi. Some toxic secondary metabolites of fungal growth are identiﬁed as mycotoxins, and may be foundto contaminate agricultural products .The contamination by mycotoxins can occur during pre-harvest at farm level, after harvest handling, storageand food processing. Among many mycotoxins, aﬂatoxins (AF) and fumonisins (FUM), are widespread inmajor cash-crops, agricultural commodities and their products in Africa. AF are highly carcinogenic, causeimmune-system suppression, exert hepatocellular damage and even death in both humans and domesticanimals. Furthermore, in the past, AFs exposure has caused acute outbreaks resulting in many casualties.Dietary exposure to AF in childhood occurs mainly through complementary infant foods and carryover viabreast milk. Comparator(s)/controlNot applicablePrimary outcome(s)This review will consider studies that include the following outcome measures:• Child growth as measured by anthropometric measurements, such as weight for length/height, weight forage, length/height for age, mid-upper arm circumference (MUAC) and head circumference.• Morbidity: hepatic, gastrointestinal and respiratory diseases. Marasmus, kwashiorkor and marasmic-kwashiorkor.• Deaths occurring for children under ﬁve years of age: perinatal mortality, neonatal mortality, infant mortalityand child mortality.• Studies on immune system of under-ﬁves. Secondary outcome(s)Not applicable Data extraction (selection and coding)First, we will screen titles and abstracts retrieved through the search strategies in various electronicbibliographic databases for inclusion, then full texts will be examined in detail and screened for eligibility. Wewill hand search reference lists of eligible studies for additional articles. We will contact study authors andwill ask them to provide additional information and further relevant references, if necessary.KT will perform initial screening of studies by title. Next, KT, MDB and CL will assess the abstracts and thefull text articles for eligibility. Every manuscript and paper will be reviewed by at least 2 reviewers at thisstage. In case of disagreement, PK will be consulted for ﬁnal decision.Data will be extracted from articles using a template designed for this review. We will pilot the data collectionform in a few studies and modiﬁcations will be made where necessary. The data extraction will includespeciﬁc details about the author and year of publication, interventions/exposure, study population, studymethods and designs, study setting, sample size, outcome measurement, outcome measurement method,biomarkers, outcomes of signiﬁcance to the review question and speciﬁc objectives.  Risk of bias (quality) assessmentThe methodological quality and bias of epidemiological studies will be evaluated using the Newcastle-Ottawa scale for observational studies. Each study will be judged on various items, categorized into threegroups: the selection of the study groups, the comparability of the groups, the exposure and the outcome ofinterest for observational studies. The reviewers will make decision on the classiﬁcation of risk of bias. Thequality (risk of bias) for each observational study will be independently assessed by two reviewers.Discrepant scores will be resolved by discussion with a third reviewer.To critically appraise the validity of each randomized and non-randomized trial included in this study, theCochrane Collaboration’s Risk of Bias Tool will be used.Strategy for data synthesis21/02/2018 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046 3/4Where appropriate meta-analyses will be done to quantify the results of different studies. We will use the I²statistic to measure heterogeneity across studies. A random-effects meta-analysis will be used toincorporate heterogeneity among studies. In case of substantial heterogeneity subgroup analysis will beused. Separate sensitivity and/or sub-analyses will be conducted to assess heterogeneity.We will estimate the effect of the intervention/exposure using odds ratios or risk ratio/risk difference fordichotomous data, together with their respective conﬁdence intervals and mean difference or standardizedmean difference for continuous data, together with the 95% appropriate associated conﬁdence interval. Odds ratios will be used in cross-sectional or case-control studies. In any of the observational study designs(cohort, case control and cross-sectional studies), funnel plots will be used to assess publication biasprovided that enough comparable studies are identiﬁed to conduct a meta-analysis.Two review authors will independently assess the strength of the evidence (high, moderate, low, and verylow) using the recommendations of the GRADE working group i.e. risk of bias, consistency of effect,imprecision, indirectness, and publication bias. Disagreements will be resolved through discussion with athird reviewer.When quantitative synthesis is either not appropriate or not feasible, narrative synthesis will be performed,such as a structured summary and discussion of the studies’ characteristics and ﬁndings. Further analysiswill be performed depending on the type and nature of the data. We will contact investigators to obtainmissing outcome data if necessary.Results of this study will be presented according to the PRISMA Statement.Analysis of subgroups or subsetsIf the necessary data are available, in case of substantial heterogeneity, subgroup analysis will be used.Separate sensitivity and/or sub-analyses will be conducted to assess heterogeneity across methodologicalfactors such as study design, overall study quality, length of follow-up, types of intervention/exposure,participant characteristics i.e. gender and nutritional status, geographical locations or type of variables. Contact details for further informationProf. dr. Carl Lachat Carl.Lachat@ugent.beOrganisational afﬁliation of the reviewJimma university, Ethiopia.Ghent university, Belgium. Review team members and their organisational afﬁliationsMr Kokeb Tesfamariam. College of Public Health and Medical Sciences, Department of Population andFamily Health, Jimma University, Jimma, Ethiopia. Department of Food Safety and Food Quality, Faculty ofBioscience Engineering, Ghent University, Ghent, Belgium. Email: kokiadonis@gmail.com Dr Marthe De Boevre. Laboratory of Food analysis, Department of Bioanalysis, Faculty of pharmaceuticalsciences, Ghent university, Belgium. Email: Marthe.DeBoevre@UGent.be Professor Tefera Belachew. Faculty of public health, Department of population and family health, Jimmauniversity, Ethiopia. Email: teferabelachew@gmail.com Professor Patrick Kolsteren. Faculty of Bioscience Engineering, Department of food safety and food quality,Ghent university, Belgium. Email: Patrick.Kolsteren@ugent.be Professor Carl Lachat. Faculty of Bioscience Engineering, Department of food safety and food quality, Ghentuniversity, Belgium. Email: Carl.Lachat@ugent.beAnticipated or actual start date22 November 2017Anticipated completion date22 July 2018Funding sources/sponsors21/02/2018 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82046 4/4VLIR-OUS Network program and MYTOX-SOUTH. The network program is a collaboration of four publicuniversities in Ethiopia coordinated by Jimma University (JU) and ﬁve Flemish universities coordinated byGhent University (UGent). MYTOX-SOUTH offers research and expertise that deals with the occurence ofmycotoxins and its effect on human health. Conﬂicts of interestLanguageEnglish, FrenchCountryEthiopia , BelgiumStage of reviewReview_OngoingSubject index terms statusSubject indexing assigned by CRDSubject index termsBiological Phenomena; Child; Dietary Exposure; Humans; Immune System; Mycotoxins; PhysiologicalPhenomenaDate of registration in PROSPERO04 January 2018Date of publication of this version04 January 2018Details of any existing review of the same topic by the same authorsStage of review at time of this submissionStage Started CompletedPreliminary searches Yes NoPiloting of the study selection process No NoFormal screening of search results against eligibility criteria No NoData extraction No NoRisk of bias (quality) assessment No NoData analysis No NoVersions04 January 2018PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in goodfaith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of thisregistration record, any associated ﬁles or external websites.

Dietary mycotoxins exposure and child growth, immune system, morbidity and mortality : protocol for a systematic literature review

https://biblio.ugent.be/publication/8551429/file/8551430

Dietary mycotoxins exposure and child growth, immune system, morbidity and mortality : protocol for a systematic literature review

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