Cochrane · systematic review · CD009527

Adding rapid diagnostic tests to community‐based programmes for treating malaria

Allen, EN, Wiyeh, ABeriliy, McCaul, M · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library

Infectious Diseases2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 14.3%Low 3 · 42.9%Moderate 2 · 28.6%High 1 · 14.3%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

Malaria rapid diagnostic test (mRDT) compared to clinical diagnosis in community‐based malaria programmes

Population: people with suspected malaria

CD009527.PUB3 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Mortality Malaria rapid diagnostic test (mRDT) vs clinical diagnosis	no estimate extracted	7678 participants	Very low Downgraded: imprecision
Antimalarial prescribing to microscopy‐ or PCR‐negative people Malaria rapid diagnostic test (mRDT) vs clinical diagnosis	RR 0.17 [0.07, 0.4]	7877 participants	Moderate Downgraded: imprecision, inconsistency
Composite appropriate treatment Malaria rapid diagnostic test (mRDT) vs clinical diagnosis	RR 3.04 [2.46, 3.74]	9332 participants	High
Number of people receiving an antimalarial Malaria rapid diagnostic test (mRDT) vs clinical diagnosis	RR 0.21 [0.14, 0.34]	4729 participants	Low Downgraded: risk of bias, imprecision, inconsistency
Antibiotic prescribing to microscopy‐ or PCR‐negative people Malaria rapid diagnostic test (mRDT) vs clinical diagnosis	RR 2.02 [1.21, 3.37]	5179 participants	Moderate Downgraded: imprecision

Malaria rapid diagnostic test (mRDT) in community‐based care versus health facility care for people with suspected malaria

Population: people with suspected malaria

CD009527.PUB3 (current) · 2 questions

Outcome	Effect	Evidence	Status / GRADE
All‐cause mortality and malaria mortality Malaria rapid diagnostic test (mRDT) in community‐based care vs health facility care	no estimate extracted	9428 participants	Low Downgraded: risk of bias, imprecision
Hospitalizations Malaria rapid diagnostic test (mRDT) in community‐based care vs health facility care	no estimate extracted	9428 participants	Low Downgraded: risk of bias, imprecision

Home‐ or community‐based programmes versus standard care for treating malaria

Population: Children with fever or malaria symptoms

CD009527.PUB2 · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Prompt treatment with an effective antimalarial Home‐ or community‐based programmes vs standard care	RR 4.69 [1, 22.07]	2 studies · 3099 participants	Moderate Downgraded: indirectness
All‐cause mortality Home‐ or community‐based programmes vs standard care	RR 0.58 [0.44, 0.77]	1 study · 13677 participants	Moderate Downgraded: risk of bias, indirectness
Hospitalizations Home‐ or community‐based programmes vs standard care	RR 0.63 [0.35, 1.17]	1 study · 437 participants	Very low Downgraded: imprecision, indirectness
Prevalence of parasitaemia Home‐ or community‐based programmes vs standard care	no estimate extracted	2 studies · 1443 participants	Very low Downgraded: imprecision, inconsistency
Prevalence of anaemia Home‐ or community‐based programmes vs standard care	1.33 [0.7, 2.51]	3 studies · 3612 participants	Low Downgraded: risk of bias, imprecision

Home‐ or community‐based programmes using RDT diagnosis versus the same programmes using clinical diagnosis

Population: Children with fever or malaria symptoms

CD009527.PUB2 · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Treatment with an antimalarial Home‐ or community‐based programmes using RDT diagnosis vs the same programmes using clinical diagnosis	RR 0.39 [0.18, 0.84]	2 studies · 5977 participants	Moderate Downgraded: indirectness
All‐cause mortality Home‐ or community‐based programmes using RDT diagnosis vs the same programmes using clinical diagnosis	RR 3.51 [0.68, 18.22]	2 studies · 6055 participants	Low Downgraded: imprecision, indirectness
Hospitalizations Home‐ or community‐based programmes using RDT diagnosis vs the same programmes using clinical diagnosis	RR 0.25 [0.04, 1.5]	1 study · 3125 participants	Low Downgraded: imprecision, indirectness
Treatment failure at day 7 Home‐ or community‐based programmes using RDT diagnosis vs the same programmes using clinical diagnosis	no estimate extracted	2 studies · 5994 participants	Low Downgraded: inconsistency, indirectness