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

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Analysis 2.5. Comparison 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine, Outcome 5 P. vivax parasitaemia. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine Outcome: 5 P. vivax parasitaemia Study or subgroup DHA-P AL6 Risk Ratio Risk Ratio 1 Mixed P. falciparum and vivax infection at baseline n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Ratcliff 2005 IDN 57/289 56/290 1.02 [ 0.73, 1.42 ] Kamya 2006 UGA 0/211 0/210 0.0 [ 0.0, 0.0 ] Karunajeewa 2007 PNG 0/100 0/94 0.0 [ 0.0, 0.0 ] Yeka 2007 UGA 0/215 0/199 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 815 793 1.02 [ 0.73, 1.42 ] Total events: 57 (DHA-P), 56 (AL6) Heterogeneity: Chi 2 = 0.0, df = 0 (P = 1.00); I 2 =0.0% Test for overall effect: Z = 0.13 (P = 0.90) 2 P. vivax parasitaemia by D28 Ratcliff 2005 IDN 1/234 21/239 0.05 [ 0.01, 0.36 ] Subtotal (95% CI) 234 239 0.05 [ 0.01, 0.36 ] Total events: 1 (DHA-P), 21 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 2.97 (P = 0.0030) 3 P. vivax parasitaemia by D42 Ratcliff 2005 IDN 12/207 55/216 0.23 [ 0.13, 0.41 ] Kamya 2006 UGA 2/209 11/208 0.18 [ 0.04, 0.81 ] Yeka 2007 UGA 5/212 19/196 0.24 [ 0.09, 0.64 ] Karunajeewa 2007 PNG 27/100 56/94 0.45 [ 0.32, 0.65 ] Subtotal (95% CI) 728 714 0.32 [ 0.24, 0.43 ] Total events: 46 (DHA-P), 141 (AL6) Heterogeneity: Chi 2 = 5.73, df = 3 (P = 0.13); I 2 =48% Test for overall effect: Z = 7.55 (P < 0.00001) Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.005 0.1 1 10 200 Favours DHA-P Favours AL6 140
Analysis 2.6. Comparison 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine, Outcome 6 Gametocyte development (in those negative at baseline). Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 2 Dihydroartemisinin-piperaquine vs Artemether-lumefantrine Outcome: 6 Gametocyte development (in those negative at baseline) Study or subgroup DHA-P AL6 Risk Ratio Weight Risk Ratio n/N n/N M-H,Random,95% CI M-H,Random,95% CI Kamya 2006 UGA 9/170 18/156 28.2 % 0.46 [ 0.21, 0.99 ] Yeka 2007 UGA 9/201 21/179 28.4 % 0.38 [ 0.18, 0.81 ] Zongo 2007 BFA 7/184 3/188 21.1 % 2.38 [ 0.63, 9.08 ] Mens 2007 KEN 10/64 3/61 22.3 % 3.18 [ 0.92, 11.00 ] Total (95% CI) 619 584 100.0 % 0.95 [ 0.35, 2.59 ] Total events: 35 (DHA-P), 45 (AL6) Heterogeneity: Tau 2 = 0.78; Chi 2 = 12.61, df = 3 (P = 0.01); I 2 =76% Test for overall effect: Z = 0.10 (P = 0.92) 0.1 0.2 0.5 1 2 5 10 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. 141
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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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Sagara 2005b MLI (Continued) • 25
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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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