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BACKGROUND Allergic diseases affects around 40% of children population worldwide. The coexistence of asthma, allergic rhinitis (AR), eczema, and food allergy (FA) renders allergy treatment and prevention challenging. Infant feeding strategies recommended avoiding allergenic foods to prevent allergy development and anaphylaxis. However, recent evidence suggests that early consumption of food allergens during weaning in infants at age of 4 to 6 months could result in food tolerance hence reduce the risk of developing allergies. OBJECTIVE The aim of this study is to systematically review and meta-analyze evidence on the effect of the early food introduction for prevention childhood allergic diseases. METHODS : We will conduct a systematic review of intervention through comprehensive search of various databases including PubMed, EMBASE, Scopus, CENTRAL, PsycINFO, CINAHL and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to the latest available studies in 2023. We will include randomized controlled trials (RCTs), or cluster RCT, non-RCTs and other observational studies that assess the effect of early food introduction to prevent childhood allergic diseases. RESULTS Primary outcomes will include measures related with the effect of childhood allergic diseases (i.e., asthma, allergic rhinitis, eczema and/or food allergy). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be followed for studies selection. All data will be extracted using a standardized data extraction form and quality of the studies will be assessed using the Cochrane Risk-of-Bias Tools. A ‘summary of findings’ will be tabulated for the following outcomes: (1) Total number of allergic disease(s), (2) Rate of sensitization, (3) Total number of adverse events, (4) Improvement of health –related quality of life (HRQoL) and/or (6) All-cause mortality Descriptive and meta-analysis will be performed using a random effect model in Review Manager File. Heterogeneity among selected studies will be assessed using the I2 statistic and explored through meta-regression and subgroup analyses. Data collection is expected to start in June 2023. CONCLUSIONS The results acquired from this study will contribute to existing literature and harmonize recommendation for harmonizing infant feeding guidelines with regards to prevention of childhood allergic diseases. CLINICALTRIAL International Prospective Register for Systematic Reviews (PROSPERO) number CRD42021256776 was registered on 25 June 2021. |
