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Table 4 GRADE assessment of studies of case management on cause specific neonatal mortality due to neonatal sepsis

From: Effect of case management on neonatal mortality due to sepsis and pneumonia

  Quality Assessment Summary of Findings
      No. of Events Effect
No. of studies Design Limitations Consistency Generalizability to Population of Interest Generalizability of the Intervention of interest Intervention Control Relative Risk (95% CI)
Mortality Sepsis – community based oral antibiotic studies
No studies identified
Mortality Sepsis – community based injectable antibiotic studies
2 Observational 1 study has no control group Yes: both show low CFRs (3.3%, 4.4%) Yes, both studies were done in high neonatal mortality regions. Direct 133/2211 N/A N/A
1 Non randomized - concurrent control trial Change in sepsis specific mortality rate in intervention and control areas is not given The results of this study were consistent with the RCT Yes, study was done in a high neonatal mortality region. Indirect 54/1783 113/2048 0.56
(0.41-0.77)
1 RCT Sepsis specific reduction in mortality not given Reported similar results as study above Yes, study was done in a high neonatal mortality region. Indirect 82/2812 125/2872 0.22
(0.07-0.71)
CFR=4.4%
Mortality Sepsis/Meningitis - case management in hospitals
55 All observational study designs All observational with varied study setting, from high-income to low-income countries. In low-income countries self-selecting populations because most births happen at community level. CFR range from 67 to 6.7% *NMR LEVEL5= 5 studies
NMR LEVEL4=17 studies
NMR LEVEL 3= 5 studies
NMR LEVEL2=5 studies
NMR LEVEL1=22 studies
Multi country=1
In countries with high skilled attendance hospital data generalizable to all population. But in low-income countries, hospital data not given as most births at home N/A N/A N/A
  1. *NMR LEVELs (1=NMR <5 per 1000 live births, 2=NMR 6 to 15 per 100 live births, 3= NMR 15 to 30 per 100 live births, 4=NMR 31-45 per 100 live births 5=NMR >45 per 100 live births