Epidemiology of necrotizing enterocolities and its predictors among preterm newborns in Ethiopia: a systematic review protocol

Abstract Background Necrotizing enterocolitis is a serious intestinal inflammation that can lead to tissue death in premature infants. It is most common in infants born before 37 weeks of pregnancy. Globally, a significant number of premature babies affected by this problem with the great variation across countries due to different factors. Evidence on the epidemiology and predictors of necrotizing enterocolitis is essential for policymakers and program planners to improve prevention and treatment strategies. Therefore, this systematic review aims to evaluate the epidemiology of necrotizing enterocolitis and its predictors among preterm newborns in Ethiopia. Methods This systematic review will search for and extract data from the JBI Database, Cochrane Database, MEDLINE, CINAHL, EMBASE, PEDro, POPLINE, Proquest, OpenGrey (SIGLE), Google Scholar, Google, APA PsycInfo, Web of Science, Scopus, and HINARI. Unpublished studies and grey literature will also be searched from different sources. The review will include quantitative observational studies and experimental studies that report on the prevalence or incidence of necrotizing enterocolitis in Ethiopia from January 1, 1990 to September 30, 2023. The Newcastle–Ottawa Quality Assessment Scale will be used to select eligible studies. Two researchers will independently assess the quality of the included studies and extract the data. They will resolve any discrepancies through discussion. Heterogeneity, or variation between the studies, will be assessed using forest plots and the I2 statistic. If there is a lot of heterogeneity, a random-effects model will be used to pool the data. Subgroup analysis will be used to explore the possible sources of this heterogeneity. Publication bias, or the tendency for studies with positive results to be more likely to be published, will be assessed using funnel plots and Egger's regression test. The statistical software package STATA version 17 will be used to conduct the meta-analysis. An association will be considered statistically significant if the p-value is less than 0.05. Discussion Necrotizing enterocolitis is a significant problem in Ethiopia that affects premature newborns and can have severe consequences. More recent systematic reviews are needed to develop effective prevention and treatment strategies. Systematic review registration number in PROSPERO: CRD42023459199