Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process

Lenters, Lindsey M; Wazny, Kerri; Webb, Patrick; Ahmed, Tahmeed; Bhutta, Zulfiqar A

doi:10.1186/1471-2458-13-S3-S23

Table 3 Moderate acute malnutrition: quality assessment of evidence at the category level

From: Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process

	Quality Assessment				Summary of Findings
Number of studies	Design	Limitations	Consistency	Generalizability to population of interest	Events in intervention group	Events in control group	Effect size (95% CI)
Mortality: Moderate/high outcome specific quality					Risk Ratio
4	RCT/ cRCT	1 high, 2 moderate/high and 1 low quality study	1 of 3 studies shows beneficial effect, I²=0%	Children 6-60 months presenting to health centres with MAM, all in Africa	30	20	0.92 (0.52 to 1.64)
Non-response rate: Moderate outcome specific quality					Risk Ratio
4	RCT/ cRCT	1 high, 2 moderate/high and 1 low quality study	All studies show beneficial effect, I² = 57%	Children 6-60 months presenting to health centres with MAM, all in Africa	176	312	0.65 (0.47 to 0.90)
Recovery rate: Moderate/low outcome specific quality					Risk Ratio
5	RCT/ cRCT	1 high, 2 moderate/high, 1 moderate & 1 low quality study	All studies show beneficial effect, heterogeneous (I² = 75%)	Children 6-60 months presenting to health centres with MAM, all in Africa	2,992	1,918	1.11 (1.04 to 1.18)
Rate of height gain: Moderate outcome specific quality					Mean Difference
2	RCT	1 moderate/high, 1 low quality study	Consistent, I² = 0%	Children 6-60 months presenting to health centres with MAM, all in Africa	N/A	N/A	-0.00 (-0.02 to 0.02)
Rate of MUAC gain: Moderate outcome specific quality					Mean Difference
2	RCT	1 moderate/high, 1 low quality study	Consistent, I² = 0%	Children 6-60 months presenting to health centres with MAM, all in Africa	N/A	N/A	0.04 (0.01 to 0.07)
Rate of weight gain: Moderate/low outcome specific quality					Mean Difference
3	RCT	1 moderate/high, 1 moderate and 1 low quality study	Heterogeneous (I² = 84%)	Children 6-60 months presenting to feeding centers with MAM, all in Africa	N/A	N/A	0.61 (0.24 to 0.99)
Weight-for-height z-score change at completion or discharge: Moderate/low outcome specific quality					Mean Difference
2	RCT	1 high, 1 low quality study	Heterogeneous (I² = 46%)	Children 6-60 months presenting to feeding centres with MAM, all in Africa	N/A	N/A	0.11 (0.04 to 0.17)

(c)RCT: (cluster-) randomized controlled trial

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