Safe child feces disposal practices and its association with reported diarrhea in low-income and middle-income countries: A systematic review and meta-analysis protocol

Abstract

Introduction: In household environments, the improper handling of children's feces can be a significant contaminant, raising a high risk of baby exposure. Several studies done on the magnitude of safe disposal of child feces and its association with reported childhood diarrhea have varied outcomes and no tries have been made to systematically review this. Therefore, a systematic review is necessary to provide an exhaustive summary of the current evidence. Thus, the objective of this a systematic review and meta-analysis will be to pool out the available evidence on the magnitude of safe child feces disposal practices and its association with reported childhood diarrhea in low-income and middle-income countries. Methods: In order to find applicable literature for this study, PubMed, Science Direct, the Cochrane Library collection and Ovid Medline will be searched. In addition, it can search for Google Search Engine, Google Scholar, and references from other studies.The primary outcome of interest will be the magnitude of safe child feces disposal practices and the secondary outcome will be its association with reported diarrhea. Observational studies (cross-sectional studies, case-control studies, and cohort studies) written in English, from January 2000 onwards will be included. The selected studies will be critically appraised by two independent reviewers using an appropriate tool. The pooled magnitude of safe child feces disposal practices and its association with reported childhood diarrhea will be analyzed using Stata version 16. Heterogeneity will be assessed using the chi-square test (Q-test) statistics and inverse variance index (I2). Forest plots will be used to present the combined estimate with 95% CI. A funnel plot and Egger’s test of small study bias will be used to assess publication bias.Discussion: This systematic review will identify the evidence available on the magnitude of safe child feces disposal practices and its association with reported diarrhea. The findings from this study will be made publicly available in a repository and published in a peer-reviewed journal. The findings from this study will also provide directions for future research and public health professionals with an understanding of the importance of safe child feces disposal practices to preventing childhood diarrhea in the community.Systematic review registration number: PROSPERO CRD42020189034