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Table 2 Quality assessment of studies of community case management for the treatment of pneumonia

From: Effect of community based interventions on childhood diarrhea and pneumonia: uptake of treatment modalities and impact on mortality

  Quality Assessment Summary of Findings
  Directness No of events  
No of studies Design Limitations Consistency Generalizability to population of interest Generalizability to intervention of interest Intervention Control Relative Risk (95% CI)
ALRI mortality 0–1 months: moderate outcome specific quality of evidence
Four Concurrent No Major 3 of 4 studies show benefit Africa and Asia 3 of 4 studies WHO case management by local health workers 384 686 0.58 (0.44–0.77)
ALRI specific mortality 0–1 year: moderate outcome specific quality of evidence
Six Concurrent No major limitations Heterogeneity from meta-analysis, All studies show benefit Africa and Asia 4 of 6 studies WHO case management 916 1510 0.59 (0.46–0.75)
Two Before/After High ALRI incidence Heterogeneity from meta-analysis, All studies show benefit Asia 1 of 2 studies WHO case management 7 34 0.36 (0.16–0.82)
Seven Concurrent; before/ after See Above Heterogeneity from meta-analysis, All studies show benefit Africa and Asia See Above 917 1522 0.57 (0.44–0.75)
Nine Concurrent; before/ after See Above Heterogeneity from meta-analysis, All studies show benefit Africa and Asia See Above 938 1569 0.58 (0.50– 0.67)
ALRI-specific mortality 1–4 years: low outcome specific quality of evidence
Two Before/After High ALRI incidence Both studies show benefit Asia 1 of 2 studies WHO case management 10 24 0.51 (0.24–1.07)
ALRI-specific mortality 0-4 years: moderate outcome specific quality of evidence
Eight Concurrent No major limitation Five of eight studies show benefit Africa and Asia 6 of 8 studies WHO case management 705 948 0.68 [0.53, 0.86]
Six Before/After No major limitation Four of six studies show benefit Africa and Asia 3 of 5 studies WHO case management 220 271 0.77 [0.54, 1.08]
Ten Concurrent; before/ after See Above Eight of ten studies show benefit Africa and Asia See Above 724 986 0.67 [0.51, 0.88]
Eleven Concurrent; before/ after See Above Nine of eleven studies show benefit Africa and Asia See Above 744 1032 0.68 [0.53, 0.88]
All cause mortality 0–1months: moderate outcome specific quality of evidence
Five Concurrent No major limitation All studies show benefit Africa and Asia 4 of 5 studies WHO case management 925 957 0.73 (0.65– 0.82)
All-cause mortality 0–1 year: moderate outcome specific quality of evidence
Six Concurrent No Major limitation All studies show benefit Africa and Asia 4 of 6 studies WHO case management 2095 2487 0.78 (0.71– 0.85)
Two Before/After High ALRI incidence All studies show benefit Asia only 1 of 2 studies WHO case management 41 100 0.60 (0.42–0.85)
Seven Concurrent; before/ after See above All studies show benefit Africa and Asia See above 2114 2524 0.77 (0.70– 0.85)
Nine Concurrent; before/ after See Above All studies show benefit Africa and Asia See above 2230 2703 0.79 (0.72–0.86)
All-cause mortality 1–4 years: low outcome specific quality of evidence
Two Before/After High ALRI incidence Both studies show benefit Only Asia 1 of 2 studies WHO case management 43 82 0.49 (0.34–0.70)
All-cause mortality 0–4 years: moderate outcome specific quality of evidence
Nine Concurrent No major limitation Six studies show benefit Africa and Asia 6 of 9 studies WHO case management 3115 4180 0.83 [0.73, 0.95]
Six Before/After No major limitation Four studies show benefit Africa and Asia 3 of 6 studies WHO case management 1141 1063 0.90 [0.64, 1.26]
Eleven Concurrent; before/ after No major limitation See Above Africa and Asia See Above 3113 4401 0.80 [0.77, 0.83]
Twelve Concurrent; before/ after No major limitation See Above Africa and Asia See Above 3214 4473 0.80 [0.77, 0.83]