The first section of Table 1 summarizes the details of the 10 studies reporting data on children admitted with severe malaria over the period 1992 to 2010 from 15 centers in 11 sSA countries. In total, these involved 7,208 children, including
461 with concomitant IBI, mean case fraction 6.4% (95% confidence interval (CI) 5.81 to 6.98%). Eight studies involved children with all types of severe malaria, including one randomized controlled trial, whereas two only included children with cerebral malaria. With one exception [13], all studies used a positive blood slide as part of their severe malaria definition. The data from these 10 studies are summarized in Table 3, together with an assessment of the study quality. The case fraction with IBI varied according to study quality from 6.01% (95% CI 5.27 to 6.74) in the highest ranked studies including 256 bacteremias in 4,261 cases to 8.2% (95% CI 5.92 to 24.26%) involving 50 bacteremias in 610 children in the lowest ranked studies (Table 3).
The Q test and I2 statistic were 40.1 and 77.5, respectively,
indicating substantial heterogeneity and between-study
variability; thus, a formal meta-analysis was not performed.
Of note, other studies, not included in this table, described
other bacterial infections (pneumonia [14,15], meningitis
[16-18] and urinary tract infections [19-21]) complicating
malaria. Only three studies included information on a
non-malaria comparator group [22-24].