Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review

<b>Context:</b> Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children’s malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children’s health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. <b>Methods:</b> The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. <b>Results:</b> The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. <b>Conclusion:</b> The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.

背景：居住在贫民窟的儿童罹患营养不良的风险显著高于普通群体。目前尚无已发表的综述，系统梳理针对贫民窟儿童的营养改善干预措施及儿童营养不良的危险因素。深化对贫民窟社区儿童营养不良危险因素及干预措施对儿童健康影响的认知，可为一线从业者与政策决策者提供科学参考。本综述旨在提供此类关键信息。
方法：本次检索共纳入30个电子书目数据库，以及截至2013年12月发表的所有相关符合纳入标准的研究。
结果：本次检索共检索到1512条文献引用。随后对226项研究的全文以及16项研究的摘要进行了相关性筛选。最终纳入58项独立研究，其中22项聚焦于干预措施，38项聚焦于营养不良危险因素。所有纳入的干预措施均为营养特异性干预，其中营养干预为最主流的干预类型。经评估，73%的干预措施效果显著。
结论：本研究结果凸显了现有认知的短板——在针对营养不良高风险儿童开展质量评估、制定可实现干预精准靶向的项目化推荐方案等领域，仍存在知识空白。此外，本综述为2015年考克兰系统综述方案（Cochrane Systematic review protocol 2015）提供了研究基础，该方案将评估干预措施对各项结局指标的影响。