Artemisinin-based combination therapy for ... - The Cochrane Library

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4.2 Asia 3 836 Risk Ratio (M-H, Fixed, 95% CI) 1.43 [0.53, 3.86] 5 P. vivax parasitaemia 5 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 5.1 Mixed P. falciparum and vivax infection at baseline 5 1279 Risk Ratio (M-H, Fixed, 95% CI) 1.30 [0.57, 3.00] 5.2 P. vivax parasitaemia by day 28 1 208 Risk Ratio (M-H, Fixed, 95% CI) 0.22 [0.01, 3.88] 5.3 P. vivax parasitaemia by day 42 4 1003 Risk Ratio (M-H, Fixed, 95% CI) 0.30 [0.21, 0.41] 6 Gametocyte development (in those negative at baseline) 3 883 Risk Ratio (M-H, Fixed, 95% CI) 1.33 [0.54, 3.28] 7 Gametocyte carriage 3 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 7.1 Gametocyte carriage day 0 1 294 Risk Ratio (M-H, Fixed, 95% CI) 0.11 [0.01, 2.10] 7.2 Gametocyte carriage day 3 2 536 Risk Ratio (M-H, Fixed, 95% CI) 0.56 [0.21, 1.48] 7.3 Gametocyte carriage day 7 3 636 Risk Ratio (M-H, Fixed, 95% CI) 0.35 [0.14, 0.85] 7.4 Gametocyte carriage day 14 2 536 Risk Ratio (M-H, Fixed, 95% CI) 0.41 [0.08, 2.10] 8 Serious adverse events (including deaths) 7 1773 Risk Ratio (M-H, Fixed, 95% CI) 2.96 [0.64, 13.76] 9 Early vomiting 6 1479 Risk Ratio (M-H, Fixed, 95% CI) 1.07 [0.55, 2.08] Comparison 7. Artesunate plus mefloquine vs Artesunate plus amodiaquine Outcome or subgroup title No. of studies No. of participants Statistical method Effect size 1 Total Failure (P. falciparum) Day 28 PCR unadjusted 1 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 1.1 Africa 1 493 Risk Ratio (M-H, Fixed, 95% CI) 0.54 [0.12, 2.46] 2 Total Failure (P. falciparum) Day 28 PCR adjusted 1 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 2.1 Africa 1 482 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 3 Gametocyte carriage 1 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 3.1 Gametocyte carriage day 0 1 505 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 3.2 Gametocyte carriage day 3 1 505 Risk Ratio (M-H, Fixed, 95% CI) 17.31 [0.90, 332.99] 3.3 Gametocyte carriage day 7 1 505 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 3.4 Gametocyte carriage day 14 1 505 Risk Ratio (M-H, Fixed, 95% CI) Not estimable Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 114
Comparison 8. Artesunate plus mefloquine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome or subgroup title No. of studies No. of participants Statistical method Effect size 1 Total Failure (P. falciparum) Day 28 PCR unadjusted 1 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 1.1 Africa 1 300 Risk Ratio (M-H, Fixed, 95% CI) 1.08 [0.15, 7.59] 2 Total Failure (P. falciparum) Day 28 PCR adjusted 1 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 2.1 Africa 1 296 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 3 Gametocyte carriage 1 Risk Ratio (M-H, Fixed, 95% CI) Subtotals only 3.1 Gametocyte carriage day 0 1 306 Risk Ratio (M-H, Fixed, 95% CI) 0.10 [0.01, 1.81] 3.2 Gametocyte carriage day 3 1 306 Risk Ratio (M-H, Fixed, 95% CI) 0.21 [0.06, 0.70] 3.3 Gametocyte carriage day 7 1 306 Risk Ratio (M-H, Fixed, 95% CI) 0.03 [0.00, 0.47] 3.4 Gametocyte carriage day 14 1 306 Risk Ratio (M-H, Fixed, 95% CI) Not estimable Comparison 9. Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome or subgroup title No. of studies No. of participants Statistical method Effect size 1 Total Failure (P. falciparum) Day 28 PCR unadjusted 9 Risk Ratio (M-H, Fixed, 95% CI) Totals not selected 1.1 East Africa 3 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 1.2 West Africa 5 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 1.3 South/Central Africa 1 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 2 Total Failure (P. falciparum) Day 28 PCR adjusted 8 1729 Risk Ratio (M-H, Fixed, 95% CI) 1.65 [0.95, 2.87] 2.1 East Africa 2 365 Risk Ratio (M-H, Fixed, 95% CI) 0.83 [0.15, 4.59] 2.2 West Africa 5 1245 Risk Ratio (M-H, Fixed, 95% CI) 1.81 [1.00, 3.26] 2.3 South/Central Africa 1 119 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 3 Gametocyte development 1 305 Risk Ratio (M-H, Fixed, 95% CI) 0.34 [0.15, 0.74] 4 Gametocyte carriage 3 Risk Ratio (M-H, Fixed, 95% CI) Totals not selected 4.1 Gametocyte carriage day 0 3 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 4.2 Gametocyte carriage day 3 1 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 4.3 Gametocyte carriage day 7 3 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 4.4 Gametocyte carriage day 14 2 Risk Ratio (M-H, Fixed, 95% CI) Not estimable 5 Anaemia 5 Mean Difference (IV, Fixed, 95% CI) Totals not selected 5.1 Mean haemoglobin (g/dl) at baseline 4 Mean Difference (IV, Fixed, 95% CI) Not estimable 5.2 Mean haemoglobin (g/dl) at Day 28 1 Mean Difference (IV, Fixed, 95% CI) Not estimable 5.3 Mean change in haemoglobin (g/dl) from baseline to Day 28 1 Mean Difference (IV, Fixed, 95% CI) Not estimable Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 115
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Artemisinin-based combination thera
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Analysis 2.2. Comparison 2 Dihydroa
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Analysis 10.5. Comparison 10 Arteme
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[Intervention Review] Artemisinin-b
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B A C K G R O U N D Malaria is a di
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drugs and the treatment comparisons
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this analysis into participants who
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Figure 1. Methodological quality su
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confidence intervals of the estimat
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Anaemia Hasugian 2005 IDN found tha
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Three trials report significantly m
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or those treated for P. vivax at ba
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Early vomiting Not reported. D I S
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Figure 4. Olliaro-Vaillant plot. Da
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Figure 10. Olliaro-Vaillant plot. D
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of findings tables’. For these ta
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Huambo and Bie provinces, central A
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References to studies excluded from
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Adjuik 2004 Adjuik M, Babiker A, Ga
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C H A R A C T E R I S T I C S O F S
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Ashley 2003a THA (Continued) Outcom
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Ashley 2003b THA (Continued) Alloca
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Ashley 2005 THA (Continued) Exclusi
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Bonnet 2004 GIN (Continued) Item Au
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Bukirwa 2005 UGA Methods Trial desi
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Djimde 2004 MLI (Continued) • AS
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Dorsey 2006 UGA (Continued) Item Au
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Fanello 2004 RWA Methods Trial desi
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Faye 2003 SEN (Continued) Outcomes
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Grande 2005 PER (Continued) Allocat
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Guthmann 2004 AGO (Continued) All d
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Hasugian 2005 IDN Methods Trial des
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Analysis 8.2. Comparison 8 Artesuna
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Analysis 9.2. Comparison 9 Artemeth
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(... Continued) Study or subgroup A
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Analysis 9.8. Comparison 9 Artemeth
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Analysis 12.2. Comparison 12 Artesu
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Analysis 14.2. Comparison 14 Dihydr
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(... Continued) Study or subgroup D
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Analysis 20.1. Comparison 20 How do
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Analysis 21.1. Comparison 21 How do
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(Continued) 2. How does artesunate
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(Continued) Sensitivity analysis 1
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(Continued) Smithuis 2004 MMR (652
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Dihydroartemisinin-piperaquine vs A
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(Continued) Mayxay 2003 LAO (220 pa
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Artesunate plus mefloquine vs Amodi
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(Continued) Faye 2003 SEN (509 part
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Artemether-lumefantrine vs Artesuna
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(Continued) Zongo 2005 BFA (521 par
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(Continued) Faye 2003 SEN (521 part
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PCR = polymerase chain reaction PCV
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(Continued) Proportion with anaemia
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(Continued) Vivax efficacy: P. viva
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(Continued) Efficacy: Total Failure
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(Continued) Outcomes Illustrative c
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(Continued) GRADE Working Group gra
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Footnotes 1 Data were also availabl
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8 Very serious imprecision: There w
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(Continued) justed Vivax efficacy:
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(Continued) Harms: Serious adverse
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(Continued) Harms: Early vomiting -
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1 Dorsey 2006 UGA; Faye 2003 SEN; K
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