Fig 1.
Article selection flowchart.
Fig 2.
(A) Diarrhea duration, (B) Stool Frequency at day 2, (C) Diarrhea at day 3, (D) Vomiting and (E) Side effects. Nodes are proportional to the number of patients included in the corresponding treatments, and edges are weighted according to the number of studies included in the respective comparisons. Interventions' abbreviations: ALL-PRB: All probiotics, except LGG and SB; CAO: Kaolin-Pectin; DM: Diluted Milk; LCF: lactose-free formula; LCF+PRB: Lactose Free Formula + Probiotics; LGG: L. rhamnosus-GG; LGG+SM: LGG + Smectite; LOP: Loperamide; MN: Micronutrients; PRE: prebiotics; RC: Racecadotril; SB: Saccharomyces boulardii; SB+LCF: S. boulardii + Lactose-Free Formula; SB+ZN: S. boulardii + Zinc; SB+ZN+LCF: S. boulardii + Zinc + Lactose free Formula; SM: Smectite; SM+ZN: Smectite + Zinc; STND: Standard treatment or Placebo; SYM: Symbiotics; SYM+LCF: Symbiotics + Lactose-Free Formula; VA: Vitamin A; YOG: Yogurt; YOG+PRB+ZN: Yogurt + Probiotics + Zinc; ZN: Zinc; ZN+LCF: Zinc + Lactose Free Formula; ZN+MN: Zinc + micronutrients; ZN+PRB: Zinc + Probiotics.
Table 1.
Classification of interventions.
Fig 3.
League table with NMA estimates for diarrhea duration and stool frequency at day 2.
Comparisons should be read from left to right. The effectiveness estimate is located at the intersection of the column- defining treatment and the row-defining treatment. Diarrhea duration (bottom part of the table) effect estimate is presented in mean difference in hours with the 95% CrI, an MD below 0 favors the column- defining treatment (fewer hours of diarrhea). Stool frequency at day 2 (upper part of the table) effects estimate is presented in mean difference in the number of stools with the 95% CrI, an MD below 0 favours the column-defining treatment (fewer stools per day). To obtain MDs for comparisons in the opposing direction, negative values should be converted into positive values and vice versa. Significant results are in bold and underlined. Cells filling represent the GRADE quality of evidence assessment: Green: High quality; Light Green: Moderate quality; Light Orange: Low; Darker Orange: Very Low. Blank cells: not available interventions and comparisons MD: Mean difference; 95CrI%: 95% Credible Intervals; NMA: Network Meta- analysis. Interventions' abbreviations are described in Table 1.
Table 2.
Summary of results for diarrhea duration in hours.
Fig 4.
Forest plot of subgroup analyses by country income classification.
All interventions are compared to STND. Subgroup analyses were performed based on the country income classification (based on the World Bank classification at 2016) Comparisons are highlighted in Dark Grey if the GRADE Quality was Low or Very Low, and in Light grey, when Quality was High or Moderate. When an intervention has no effect estimate in HIC means that there were no studies in HIC for the mentioned interventions. MD: Mean difference; 95CrI%: 95% Credible Intervals; LMIC: Low- and Middle-Income countries; HIC: High-income countries. Interventions' abbreviations are described in Table 1.
Fig 5.
League table with NMA estimates for diarrhea at day 3 and vomiting.
Comparisons should be read from left to right. The effectiveness estimate is located at the intersection of the column-defining treatment and the row-defining treatment. Diarrhea at day 3 (bottom part of the table) effect estimates are presented in odds ratio (OR) with the 95% CrI. A OR below 1.0 favours the column- defining treatment (less presence of diarrhea at day 3). Vomiting (upper part of the table) effect estimates are presented in Odds ratio (OR) with the 95% CrI, an OR below 1.0 favors the column-defining treatment (less presence of vomiting). To obtain ORs for comparisons in the opposing direction, reciprocals should be taken. Significant results are in bold and underlined font. Cells filling represent the GRADE quality of evidence assessment: Green: High quality; Light Green: Moderate quality; Light Orange: Low; Darker Orange: Very Low. Blank cells: not available interventions and comparisons. OR: Odds Ratio; 95CrI%: 95% Credible Intervals; NMA: Network Meta-analysis. Interventions' abbreviations are described in Table 1.
Fig 6.
League table with NMA estimates for side effects.
Comparisons should be read from left to right. The effectiveness estimate is located at the intersection of the column-defining treatment and the row-defining treatment. Side effects estimates are presented in odds ratio (OR) with the 95% CrI, an OR below 1.0 favors the row-defining treatment (less presence of side effects). To obtain ORs for comparisons in the opposing direction, reciprocals should be taken. Significant results are in bold and underlined. Cells filling represent the GRADE quality of evidence assessment: Green: High quality; Light Green: Moderate quality; Light Orange: Low; Darker Orange: Very Low. OR: Odds Ratio; 95CrI%: 95% Credible Intervals. Interventions' abbreviations are described in Table 1.