Table 3.

Quality assessment of trials of the evidence for IRS to prevent malaria deaths in children <5 years old

Quality assessment						Summary findings
				Directness		Intervention		Control
No. of studies	Design	Limitations	Consistency	Generalizability to population of interest	Generalizability to intervention of interest	No. of events	Denominator	No. of events	Denominator	Pooled RR (95% CI)
ACCM: low outcome-specific quality
2	Before/after	Serious	χ2 for heterogeneity (1 df) = 11.8	High	High	190	2000	373	2000	0.53a (0.40–0.71)
All-cause infant mortality: low outcome-specific quality
3	Before-after	Serious	χ2 for heterogeneity (2 df) = 10.2	High	High	235	9542	477	9080	0.47a (0.40–0.54)
Uncomplicated malaria incidence: low outcome-specific quality
3	Before/after	Serious	χ2 for heterogeneity (2 df) > 100	High	High	Unknown	Unknown	Unknown	Unknown	0.25a (0.03–2.23)
Prevalence of malaria parasite infection: low outcome-specific quality
5	Before/after	Serious	χ2 for heterogeneity (4 df) > 100	High	High	Unknown	Unknown	Unknown	Unknown	0.16a (0.03–0.94)

A limitation = serious means that there is a substantial threat of bias based on the study design used.

^aRandom effects model.