¹ Only one randomized controlled trial of mannitol compared to placebo in children with cerebral malaria has been conducted (Namutangula 2007)
² No serious study limitations. This study adequately randomized participants, and blinded participants to be considered at low risk of bias. The method of allocation concealment was not clearly stated but was probably done
³ No serious inconsistency. Not applicable as only one study
⁴ No serious indirectness. Children aged 6‐60 months who met the WHO case definition of cerebral malaria were included. Children with renal disease, cardiac failure or pulmonary congestion were excluded. 5 mL/kg of 20% mannitol (1 g/kg) or 5 mL/kg of saline as matched placebo were administered in a single dose over 20 minutes at the same time as parenteral quinine.
⁵ Very serious imprecision. This study is not adequately powered to detect a clinically important effect on mortality. The 95% CI is wide and includes both appreciable benefit and harm with mannitol.
⁶ Serious indirectness. This outcome is an indirect or surrogate indicator for poor outcomes, and on its own is not informative.
⁷ Serious imprecision. The article presents median times to regain conciousness, to oral intake, to sit unsupported and total coma time. The differences between the groups are not statistically significant (P > 0.05).