{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:49:59Z","timestamp":1772218199277,"version":"3.50.1"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The aetiology of mechanical bowel obstruction exhibits significant variability based on geographical location and age. In high-income countries, postoperative adhesions and hernias are frequently cited as the primary causes, whereas in low- and middle-income countries (LMCIs), hernias take precedence. Speculation exists within the surgical community regarding whether this trend has evolved in LMCIs. To address this knowledge gap, our study aims to conduct a systematic review of existing literature, focusing on understanding the most prevalent causes of mechanical bowel obstruction in both pediatric and adult populations within LMCIs, providing valuable insights for surgical practice. This protocol was designed and written according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol 2015 (PRISMA-P 2015) statement. However, the results of the systematic review will be reported following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. We will consider studies published in English and French between 2002 and 2022 that reported on the aetiology of mechanical bowel obstruction in any age group in low- and middle-income countries. We will conduct a literature search using Ovid MEDLINE, Ovid Embase, CINAHL on EBSCO and Web of Science databases employing relevant subject headings, keywords and synonyms, which will be combined using Boolean operators to refine the search results. A hand search of references of retrieved literature will be conducted. The retrieved articles will be imported into Zotero for de-duplication. The resulting set of titles and abstracts will be uploaded to Rayyan (an AI-assisted online systematic review tool), where they will be double-checked to identify articles eligible for inclusion. Two independent reviewers will screen articles to be included and disagreement will be resolved by discussion or by a third reviewer as a tie-breaker. Also, data extraction will be done by one reviewer and confirmed by another. Critical appraisal to assess the quality of the included studies will be carried out by two independent reviewers using the Joanna Briggs Institute (JBI) tools. We anticipate that the eligible studies will be quite heterogeneous in terms of their design, outcomes of interest, populations and comorbidities. Therefore, resmay be synthesised descriptively without meta-analysis using charts, graphs and tables. Where possible, we will conduct a sub-analysis using conceptual frameworks based on age, WHO regions and continents.<\/jats:p>","DOI":"10.1371\/journal.pone.0295477","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T13:50:14Z","timestamp":1715262614000},"page":"e0295477","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic review protocol of aetiology of mechanical bowel obstruction in low-and-middle income countries: Has anything changed in the last two decades?"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0555-9220","authenticated-orcid":true,"given":"Yakubu Kevin","family":"Kwarshak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7992-3494","authenticated-orcid":true,"given":"Mohammed Nakodi","family":"Yisa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9129-6729","authenticated-orcid":true,"given":"Oghenegare Asheaba","family":"Kigbu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Akut","family":"John","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2093-4644","authenticated-orcid":true,"given":"Nankam David","family":"Jimwan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen Chineme","family":"Ubabuike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Mkurtar","family":"Yawe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"issue":"3","key":"pone.0295477.ref001","first-page":"268","article-title":"Etiology, management, and survival of acute mechanical bowel obstruction: Five-year results of a training and research hospital in Turkey","volume":"25","author":"D. \u00d6. Karaka\u015f","year":"2019","journal-title":"Ulus. Travma ve Acil Cerrahi Derg."},{"issue":"3","key":"pone.0295477.ref002","doi-asserted-by":"crossref","first-page":"432","DOI":"10.3748\/wjg.v13.i3.432","article-title":"Acute mechanical bowel obstruction: Clinical presentation, etiology, management and outcome","volume":"13","author":"H. Markogiannakis","year":"2007","journal-title":"World J. Gastroenterol."},{"issue":"3","key":"pone.0295477.ref003","first-page":"215","article-title":"Causes of Intestinal Obstruction in Erbil Teaching Hospital Province\u2013North of Iraq","volume":"7","author":"A. M. Zangana","year":"2008"},{"issue":"2","key":"pone.0295477.ref004","doi-asserted-by":"crossref","first-page":"4","DOI":"10.23937\/2474-3674\/1510018","article-title":"Critical Care and Emergency Medicine Aetiology and Presentation of Intestinal Obstruction among Patients Presenting to a Tertiary Hospital in Uganda ClinMed","volume":"2","author":"A. M. Nakanwagi","year":"2016","journal-title":"Int. J. Crit. Care Emerg. Med."},{"issue":"3","key":"pone.0295477.ref005","doi-asserted-by":"crossref","first-page":"118","DOI":"10.17159\/2078-5151\/2021\/v59n3a3243","article-title":"Clinicopathological spectrum of small bowel obstruction and management outcomes in adults \u2010 Experience at a regional academic hospital complex","volume":"59","author":"M. R. Mthethwa","year":"2021","journal-title":"South African J. Surg."},{"issue":"1","key":"pone.0295477.ref006","first-page":"1","article-title":"Lar Ity Search Based O N Shape Representat I on in T I M E \u2010 Ser Ies Data Sets","volume":"12","author":"J. O. U. Rnal","year":"2000","journal-title":"Electron. Publ."},{"key":"pone.0295477.ref007","doi-asserted-by":"crossref","DOI":"10.1177\/20503121221083207","article-title":"Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review","volume":"10","author":"G. 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