The Magnitude of Unsafe 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:The unsafe disposal of children’s feces may be an important contaminant in household environments, posing a high risk of exposure to infants. Several studies done on the magnitude of unsafe disposal of child feces and its association with reported childhood diarrheahave variedoutcomesand no tries have been made to systematically review this. Therefore, itis necessitating a systematic review to provide an exhaustive summary of current evidence. Thus, the objective ofthis study will be to pool out the available evidence on the magnitude of unsafe child feces disposalpractices and its association with reported childhood diarrhea in low-income and middle-income countries. Methods: PubMed, Science Direct, Cochrane Library database, and Ovid Medline will be searched to identify relevant literature for this review. Moreover, Google search engine, Google Scholar, and references of other studieswill be searched from January 2000 to December 2020. The primary outcome of interest will bethe magnitude of unsafe disposal of child feces and the secondary outcome will be its association with reported diarrhea. Observationalstudies (cross-sectional studies, case-control studies, and cohort studies) written in English will be included in this review. The selected studies will be critically appraised by two independent reviewers using an appropriate tool. The pooled magnitude of unsafe disposal of child feces 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 themagnitude of unsafe child fecesdisposal practicesand its associationwith reported diarrhea. The findings from this study will bemade 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 preventingchildhood diarrhea in the community.Systematic review registrationnumber: PROSPERO CRD42020189034