Six studies were included (n not stated): one randomised controlled trial (RCT); four controlled trials (one partially randomised); and one pre/post study.
Effectiveness in areas with mainly seasonal transmission:
An RCT (n=13,677) conducted in Ethiopia reported a significantly lower mortality rate among under-five year olds in 12 tabias (clusters of villages) randomised to receive the intervention compared with 12 control tabias (29.8 versus 50.2 per thousand, p<0.003), a reduction in the mortality rate of 40.6% (95% CI 29.2% to 50.6%). None of the other three studies that reported mortality rates found a statistically significant effect.
A controlled study in Burkina Faso (n=3,202) reported that children treated promptly with pre-packaged chloroquine and aspirin were significantly less likely to progress to severe malaria than untreated controls (risk ratio 0.47, 95% CI: 0.37 to 0.60).
A pre/post study, also in Burkina Faso, found a decrease in the proportion of malaria cases documented as severe in the first year of the programme compared to the previous three years: 3.8% (258/6,725) versus 4.9% (704/14,314), p=0.0005.
A controlled and partially randomised study conducted in 41 villages in The Gambia reported no significant findings.
Effectiveness in areas with perennial transmission:
A controlled study in two regions of the Democratic Republic of Congo (total population 28,000) reported a two-fold reduction in mean malaria prevalence and incidence and a five- to six-fold decrease in parasitological indices in the region receiving the intervention compared to the control region. However, no change in malaria mortality rates was reported and a large number of fever cases (24%) remained untreated.
A controlled study in Kenya reported no significant findings.