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