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| Format: | Recurso digital |
| Language: | English |
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2026
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| Online Access: | https://doi.org/10.5281/zenodo.18508550 |
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| _version_ | 1866901804867911680 |
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| author | Al-Timimi, Dhia J Haji, Mwafaq Ramzi |
| author_facet | Al-Timimi, Dhia J Haji, Mwafaq Ramzi |
| contents | <p>This protocol outlines the methodology for a comprehensive systematic review and meta-analysis assessing the zinc status of the Iraqi population over 36 years (1990–2026). Zinc is an essential micronutrient critical for immune function, growth, and development, with deficiency posing a significant public health burden.</p> <p><strong>Primary Aim:</strong> To synthesize existing evidence and estimate the pooled prevalence of zinc deficiency (using standard and study-specific cut-offs) and mean serum/plasma zinc levels across Iraqi demographic subgroups—including children, adults, pregnant women, the elderly, and COVID-19 patients—and to analyze trends across pre- and post-pandemic periods.</p> <p><strong>Secondary & Comparative Aims:</strong> To summarize reported dietary zinc intake patterns, explore sources of heterogeneity through subgroup and meta-regression analyses, and critically compare pooled Iraqi estimates with published data from the Middle East and North Africa (MENA) region and globally. This comparison will help determine whether Iraq faces a disproportionate burden of zinc deficiency and will identify potential regional or global disparities.</p> <p><strong>Methodology:</strong> The review will adhere to the Cochrane Handbook for Systematic Reviews of Interventions (v6.5) and will be reported following PRISMA 2020 guidelines. Comprehensive searches will be conducted across international and regional databases. Two independent reviewers will screen studies, extract data, and assess the risk of bias using the following tools: the Newcastle-Ottawa Scale (adapted) for cross-sectional studies, ROBINS-I for cohort/case-control studies, Cochrane RoB 2 for intervention study baseline data, and AMSTAR-2 for included systematic reviews. A random-effects meta-analysis using the REML estimator will be conducted where feasible, with the Hartung-Knapp-Sidik-Jonkman (HKSJ) method applied for summary confidence intervals. Where meta-analysis is not appropriate, findings will be synthesized narratively following the SWiM (Synthesis Without Meta-analysis) guideline. The review will also integrate equity considerations by extracting reported data on socioeconomic and residency factors, and will assess publication bias and certainty of evidence using GRADE.</p> <p><strong>Expected Impact:</strong> This work will provide the first consolidated and methodologically rigorous evidence on the magnitude, trends, and determinants of zinc deficiency in Iraq. The findings are intended to directly inform national nutrition policy, guide targeted interventions for high-risk groups, and situate Iraq’s nutritional health within broader regional and global contexts.</p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_18508550 |
| institution | Zenodo |
| language | eng |
| publishDate | 2026 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Systematic Review and Meta-Analysis of Zinc Status in Iraq (1990–2026): Prevalence, Trends, and Regional/Global Comparisons Al-Timimi, Dhia J Haji, Mwafaq Ramzi Zinc deficiency Zinc status Iraq Iraqi population MENA region (Middle East and North Africa) Systematic review Meta-analysis Nutritional status Micronutrients Public health nutrition COVID-19 Serum zinc Prevalence Global health Epidemiology <p>This protocol outlines the methodology for a comprehensive systematic review and meta-analysis assessing the zinc status of the Iraqi population over 36 years (1990–2026). Zinc is an essential micronutrient critical for immune function, growth, and development, with deficiency posing a significant public health burden.</p> <p><strong>Primary Aim:</strong> To synthesize existing evidence and estimate the pooled prevalence of zinc deficiency (using standard and study-specific cut-offs) and mean serum/plasma zinc levels across Iraqi demographic subgroups—including children, adults, pregnant women, the elderly, and COVID-19 patients—and to analyze trends across pre- and post-pandemic periods.</p> <p><strong>Secondary & Comparative Aims:</strong> To summarize reported dietary zinc intake patterns, explore sources of heterogeneity through subgroup and meta-regression analyses, and critically compare pooled Iraqi estimates with published data from the Middle East and North Africa (MENA) region and globally. This comparison will help determine whether Iraq faces a disproportionate burden of zinc deficiency and will identify potential regional or global disparities.</p> <p><strong>Methodology:</strong> The review will adhere to the Cochrane Handbook for Systematic Reviews of Interventions (v6.5) and will be reported following PRISMA 2020 guidelines. Comprehensive searches will be conducted across international and regional databases. Two independent reviewers will screen studies, extract data, and assess the risk of bias using the following tools: the Newcastle-Ottawa Scale (adapted) for cross-sectional studies, ROBINS-I for cohort/case-control studies, Cochrane RoB 2 for intervention study baseline data, and AMSTAR-2 for included systematic reviews. A random-effects meta-analysis using the REML estimator will be conducted where feasible, with the Hartung-Knapp-Sidik-Jonkman (HKSJ) method applied for summary confidence intervals. Where meta-analysis is not appropriate, findings will be synthesized narratively following the SWiM (Synthesis Without Meta-analysis) guideline. The review will also integrate equity considerations by extracting reported data on socioeconomic and residency factors, and will assess publication bias and certainty of evidence using GRADE.</p> <p><strong>Expected Impact:</strong> This work will provide the first consolidated and methodologically rigorous evidence on the magnitude, trends, and determinants of zinc deficiency in Iraq. The findings are intended to directly inform national nutrition policy, guide targeted interventions for high-risk groups, and situate Iraq’s nutritional health within broader regional and global contexts.</p> |
| title | Systematic Review and Meta-Analysis of Zinc Status in Iraq (1990–2026): Prevalence, Trends, and Regional/Global Comparisons |
| topic | Zinc deficiency Zinc status Iraq Iraqi population MENA region (Middle East and North Africa) Systematic review Meta-analysis Nutritional status Micronutrients Public health nutrition COVID-19 Serum zinc Prevalence Global health Epidemiology |
| url | https://doi.org/10.5281/zenodo.18508550 |