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

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Analysis 1.9. Comparison 1 Dihydroartemisinin-piperaquine vs Artesunate plus mefloquine, Outcome 9<br />

Gametocytaemia carriage.<br />

Review: <strong>Artemisinin</strong>-<strong>based</strong> <strong>combination</strong> <strong>therapy</strong> <strong>for</strong> treating uncomplicated malaria<br />

Comparison: 1 Dihydroartemisinin-piperaquine vs Artesunate plus mefloquine<br />

Outcome: 9 Gametocytaemia carriage<br />

Study or subgroup DHA-P AS+MQ Risk Ratio Weight Risk Ratio<br />

1 Gametocyte carriage day 0<br />

n/N n/N M-H,Random,95% CI M-H,Random,95% CI<br />

Smithuis 2004 MMR 137/327 103/325 52.3 % 1.32 [ 1.08, 1.62 ]<br />

Grande 2005 PER 35/262 43/260 47.7 % 0.81 [ 0.54, 1.22 ]<br />

Subtotal (95% CI) 589 585 100.0 % 1.07 [ 0.66, 1.73 ]<br />

Total events: 172 (DHA-P), 146 (AS+MQ)<br />

Heterogeneity: Tau 2 = 0.10; Chi 2 = 4.48, df = 1 (P = 0.03); I 2 =78%<br />

Test <strong>for</strong> overall effect: Z = 0.27 (P = 0.79)<br />

2 Gametocyte carriage day 7<br />

Smithuis 2004 MMR 118/322 58/318 58.3 % 2.01 [ 1.53, 2.64 ]<br />

Grande 2005 PER 17/256 9/256 41.7 % 1.89 [ 0.86, 4.16 ]<br />

Subtotal (95% CI) 578 574 100.0 % 2.00 [ 1.54, 2.58 ]<br />

Total events: 135 (DHA-P), 67 (AS+MQ)<br />

Heterogeneity: Tau 2 = 0.0; Chi 2 = 0.02, df = 1 (P = 0.88); I 2 =0.0%<br />

Test <strong>for</strong> overall effect: Z = 5.24 (P < 0.00001)<br />

3 Gametocyte carriage day 14<br />

Smithuis 2004 MMR 84/318 17/318 78.0 % 4.94 [ 3.00, 8.13 ]<br />

Grande 2005 PER 10/253 1/253 22.0 % 10.00 [ 1.29, 77.54 ]<br />

Subtotal (95% CI) 571 571 100.0 % 5.14 [ 3.17, 8.33 ]<br />

Total events: 94 (DHA-P), 18 (AS+MQ)<br />

Heterogeneity: Tau 2 = 0.0; Chi 2 = 0.43, df = 1 (P = 0.51); I 2 =0.0%<br />

Test <strong>for</strong> overall effect: Z = 6.64 (P < 0.00001)<br />

4 Gametocyte carriage day 21<br />

Smithuis 2004 MMR 26/316 0/310 49.6 % 52.00 [ 3.18, 849.49 ]<br />

Grande 2005 PER 1/247 1/250 50.4 % 1.01 [ 0.06, 16.09 ]<br />

Subtotal (95% CI) 563 560 100.0 % 7.23 [ 0.10, 519.79 ]<br />

Total events: 27 (DHA-P), 1 (AS+MQ)<br />

Heterogeneity: Tau 2 = 7.51; Chi 2 = 4.73, df = 1 (P = 0.03); I 2 =79%<br />

Test <strong>for</strong> overall effect: Z = 0.91 (P = 0.36)<br />

5 Gametocyte carriage day 28<br />

Smithuis 2004 MMR 6/318 0/314 51.3 % 12.84 [ 0.73, 226.91 ]<br />

Grande 2005 PER 3/243 0/249 48.7 % 7.17 [ 0.37, 138.12 ]<br />

0.001 0.01 0.1 1 10 100 1000<br />

Favours DHA-P Favours AS+MQ<br />

<strong>Artemisinin</strong>-<strong>based</strong> <strong>combination</strong> <strong>therapy</strong> <strong>for</strong> treating uncomplicated malaria (Review)<br />

Copyright © 2009 <strong>The</strong> <strong>Cochrane</strong> Collaboration. Published by John Wiley & Sons, Ltd.<br />

(Continued ...)<br />

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