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

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Analysis 2.3. Comparison 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine, Outcome 3 Total Failure (P. falciparum) Day 28 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine Outcome: 3 Total Failure (P. falciparum) Day 28 PCR unadjusted 1 Africa Study or subgroup DHA-P AL6 Risk Ratio Weight Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Zongo 2007 BFA 4/172 36/178 95.9 % 0.11 [ 0.04, 0.32 ] Mens 2007 KEN 0/67 1/67 4.1 % 0.33 [ 0.01, 8.04 ] Subtotal (95% CI) 239 245 100.0 % 0.12 [ 0.05, 0.32 ] Total events: 4 (DHA-P), 37 (AL6) Heterogeneity: Chi 2 = 0.39, df = 1 (P = 0.53); I 2 =0.0% Test for overall effect: Z = 4.27 (P = 0.000020) 2 Asia Ratcliff 2005 IDN 6/233 13/218 100.0 % 0.43 [ 0.17, 1.12 ] Subtotal (95% CI) 233 218 100.0 % 0.43 [ 0.17, 1.12 ] Total events: 6 (DHA-P), 13 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 1.73 (P = 0.083) 3 Oceania Karunajeewa 2007 PNG 25/111 20/113 100.0 % 1.27 [ 0.75, 2.15 ] Subtotal (95% CI) 111 113 100.0 % 1.27 [ 0.75, 2.15 ] Total events: 25 (DHA-P), 20 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 0.90 (P = 0.37) 0.01 0.1 1 10 100 Favours DHA-P Favours AL6 Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 138
Analysis 2.4. Comparison 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine, Outcome 4 Total Failure (P. falciparum) Day 28 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine Outcome: 4 Total Failure (P. falciparum) Day 28 PCR adjusted 1 Africa Study or subgroup DHA-P AL6 Risk Ratio Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Zongo 2007 BFA 4/172 6/148 0.57 [ 0.17, 1.99 ] Mens 2007 KEN 0/67 0/66 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 239 214 0.57 [ 0.17, 1.99 ] Total events: 4 (DHA-P), 6 (AL6) Heterogeneity: Chi 2 = 0.0, df = 0 (P = 1.00); I 2 =0.0% Test for overall effect: Z = 0.87 (P = 0.38) 2 Asia Ratcliff 2005 IDN 2/229 2/207 0.90 [ 0.13, 6.36 ] Subtotal (95% CI) 229 207 0.90 [ 0.13, 6.36 ] Total events: 2 (DHA-P), 2 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 0.10 (P = 0.92) 3 Oceania Karunajeewa 2007 PNG 11/97 3/96 3.63 [ 1.04, 12.60 ] Subtotal (95% CI) 97 96 3.63 [ 1.04, 12.60 ] Total events: 11 (DHA-P), 3 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 2.03 (P = 0.042) Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.01 0.1 1 10 100 Favours DHA-P Favours AL6 139
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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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Hutagalung 2002 THA (Continued) 5.
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Janssens 2003 KHM (Continued) Free
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Karema 2004 RWA (Continued) Interve
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Karunajeewa 2007 PNG (Continued) Ri
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Kobbe 2007 GHA (Continued) Exclusio
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Koram 2003 GHA (Continued) Adequate
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Martensson 2003 TZA Methods Trial d
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Mayxay 2003 LAO (Continued) 1. Feve
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Menard 2006 MDG Methods Trial desig
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Mens 2007 KEN (Continued) Risk of b
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Mutabingwa 2004 TZA (Continued) •
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Owusu-Agyei 2006 GHA (Continued) Fr
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Analysis 11.9. Comparison 11 Arteme
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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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