We searched Pubmed using the keywords “acute respiratory infections”, “acute lower respiratory infections”, “respiratory infections”, “pneumonia”, and “pneumonia case management strategy”; each term was combined with “and mortality”. The search was restricted to children, all articles, all languages, from 1970 onwards. We also contacted individual authors and the agencies WHO, USAID, and UNICEF for data on unpublished studies.
ReviewEffect of pneumonia case management on mortality in neonates, infants, and preschool children: a meta-analysis of community-based trials
Section snippets
Identification and selection of studies
We attempted to locate all published and unpublished community-based intervention trials on case management of pneumonia in preschool children in developing countries. In addition to systematic searching of the bibliographic databases, including Medline, Sci-scimate, Current Contents, and references from the identified papers, potential funding agencies such as the WHO Programme for the Control of Acute Respiratory Infections, the US Agency for International Development, and UNICEF were
Study descriptions
Baseline characteristics of study populations are presented in table 1. The pneumonia case-management studies took place in a range of settings with baseline infant mortality rates (IMR) ranging between 49 and 184 deaths/1000 live births and different levels of health services availability, as reported by the investigators (table 1). Undernutrition was prevalent in all settings for which information was available. Of the nine studies that provided data, seven had concurrent control group data;
Discussion
Our meta-analysis indicates that community-based interventions to identify and treat pneumonia have a considerable effect on child mortality. The diversity of pneumonia interventions and the developing country settings in which these trials took place, along with the consistency of the results, lends credibility to the robustness of the findings and their application to many developing countries. Although not included in meta-analysis estimates, studies with before-and-after comparison designs
Search strategy and selection criteria
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