Reporting and Methodological Quality of Clinical Practice Guidelines for Management of Malnutrition in the East African Community. A Systematic Review
Authors:   Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya., Sagam Caleb K , owino Eddy Johnson ,   Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya., Were Lisa M ,   Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya., Otieno Jenifer A ,   Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,   Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya, Munezero Belyse ,   Interdisciplinary research group in Public Health, Public Health Department University of Burundi, National Institute of Public Health, Bujumbura Burundi., Butoyi Jean M ,   Faculty of Health Sciences, Light University of Bujumbura, Bujumbura, Burundi., Nyabenda Oscar ,   Department of Public Health, Ministry of Public Health Bujumbura, Burundi., Ndibanje Gildas ,   Department of Health Sciences, Mount Kenya University, Bujumbura, Burundi., Niyukuri Jonathan ,   Department of Food Science and Technology, Faculty of Agronomy and Bioengineering, University of Burundi, Bujumbura, Burundi., Felo Maurice ,   Department of Community Health, School of Public Health, University of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo., Ochodo Eleanor A ,   Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
Published: November 2024

Background: Clinical practice guidelines (CPGs) for management of malnutrition should be supported by the highest quality of the best available evidence. CPGs serve as a practice framework for healthcare professionals to support therapeutic decisions and best practices for optimising patient care. However, if the guidelines do not sufficiently address all the important components of optimal care, the quality, validity and impact of the guidelines are reduced. Despite multiple interventions, cases of malnutrition are still high due to the several factors linked to them. Therefore, there is need to establish whether CPGs are formulated based on the best available evidence and are of good methodological quality so as to guarantee impact. We aimed to critically appraise the methodological quality and reporting of Clinical Practice Guidelines (CPGs) for managing malnutrition within the East African Community (EAC). We conducted a methodological quality assessment of the included CPGs using the online version of the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool across six domains and using the Reporting Items for Practice Guidelines in Healthcare (RIGHT) reporting checklist. We searched the Ministry of Health and Health associations websites of the EAC countries. We retrieved 47 documents and included 8 CPGs. The mean scores were: clarity of presentation 93.4%, with all guidelines scoring above 80%. Scope and purpose: 76.6%, with one guideline scoring less than 50%. Stakeholder involvement was 47.1%, with one CPG scoring over 60%. The applicability domain scored 51% with only two CPGs scoring above 60%. Editorial independence was the poorest (8.9%), with the highest CPG scoring 13%. Only 8 items were reported in all the guidelines, and 11 items were partially reported. Most items were not fully reported in most of the guidelines. The methodological quality of CPGs for managing childhood malnutrition in the EAC has significant variability, with notable strengths in clarity of presentation and scope and purpose but critical weaknesses in stakeholder involvement, editorial independence and reporting. Keywords: Childhood malnutrition, clinical practice guidelines (CPGs), AGREE II tool, RIGHT checklist, East African Community (EAC)