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

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Analysis 4.3. Comparison 4 Dihydroartemisinin-piperaquine vs Artesunate plus sulfadoxinepyrimethamine, Outcome 3 Total Failure (P. falciparum) Day 28 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 4 Dihydroartemisinin-piperaquine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 3 Total Failure (P. falciparum) Day 28 PCR unadjusted Study or subgroup DHA-P AS+SP Risk Ratio Weight Risk Ratio 1 Oceania n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Karunajeewa 2007 PNG 25/111 25/112 100.0 % 1.01 [ 0.62, 1.64 ] 0.01 0.1 1 10 100 Favours DHA-P Favours AS+SP Analysis 4.4. Comparison 4 Dihydroartemisinin-piperaquine vs Artesunate plus sulfadoxinepyrimethamine, Outcome 4 Total Failure (P. falciparum) Day 28 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 4 Dihydroartemisinin-piperaquine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 4 Total Failure (P. falciparum) Day 28 PCR adjusted Study or subgroup DHA-P AS+SP Risk Ratio Weight Risk Ratio 1 Oceania n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Karunajeewa 2007 PNG 11/97 11/98 100.0 % 1.01 [ 0.46, 2.22 ] 0.01 0.1 1 10 100 Favours DHA-P Favours AS+SP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 150
Analysis 4.5. Comparison 4 Dihydroartemisinin-piperaquine vs Artesunate plus sulfadoxinepyrimethamine, Outcome 5 P. vivax parasitaemia by day 42. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 4 Dihydroartemisinin-piperaquine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 5 P. vivax parasitaemia by day 42 Study or subgroup DHA-P AS+SP Risk Ratio Weight Risk Ratio 1 Participants with P. falciparum mono-infection at baseline n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Karunajeewa 2007 PNG 27/100 56/94 100.0 % 0.45 [ 0.32, 0.65 ] Subtotal (95% CI) 100 94 100.0 % 0.45 [ 0.32, 0.65 ] Total events: 27 (DHA-P), 56 (AS+SP) Heterogeneity: not applicable Test for overall effect: Z = 4.28 (P = 0.000019) 2 Participants with P. vivax P. falciparum at baseline Karunajeewa 2007 PNG 11/36 26/39 100.0 % 0.46 [ 0.27, 0.79 ] Subtotal (95% CI) 36 39 100.0 % 0.46 [ 0.27, 0.79 ] Total events: 11 (DHA-P), 26 (AS+SP) Heterogeneity: not applicable Test for overall effect: Z = 2.83 (P = 0.0046) 0.01 0.1 1 10 100 Favours DHA-P Favours AS+SP Analysis 5.1. Comparison 5 Dihydroartemisinin-piperaquine vs Amodiaquine plus sulfadoxinepyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 5 Dihydroartemisinin-piperaquine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 1 Total Failure (P. falciparum) Day 28 PCR unadjusted Study or subgroup DHA-P AQ+SP Risk Ratio Weight Risk Ratio 1 Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Karema 2004 RWA 24/250 66/255 85.6 % 0.37 [ 0.24, 0.57 ] Zongo 2007 BFA 4/172 11/171 14.4 % 0.36 [ 0.12, 1.11 ] 0.01 0.1 1 10 100 Favours DHA-P Favours AQ+SP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 151
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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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Smithuis 2004 MMR (Continued) Risk
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Stohrer 2003 LAO Methods Trial desi
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Swarthout 2004 ZAR (Continued) Note
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Tran 2002 VNM Methods Trial design:
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Van den Broek 2003a BGD (Continued)
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Page 113 and 114: (Continued) Fofana 2005 Conference
Page 115 and 116: D A T A A N D A N A L Y S E S Compa
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Page 121 and 122: Comparison 8. Artesunate plus meflo
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Page 127 and 128: 5.2 DHA-P 3 doses 3 1116 Risk Ratio
Page 129 and 130: Comparison 21. How does Artesunate
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Page 137 and 138: (... Continued) Study or subgroup D
Page 139 and 140: Analysis 1.12. Comparison 1 Dihydro
Page 141 and 142: (... Continued) Study or subgroup D
Page 155: Analysis 4.1. Comparison 4 Dihydroa
Page 163 and 164: (... Continued) Study or subgroup A
Page 165 and 166: Analysis 6.6. Comparison 6 Artesuna
Page 173 and 174: Analysis 9.2. Comparison 9 Artemeth
Page 177 and 178: Analysis 9.8. Comparison 9 Artemeth
Page 183 and 184: Analysis 10.2. Comparison 10 Arteme
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Analysis 14.2. Comparison 14 Dihydr
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Analysis 17.1. Comparison 17 Artesu
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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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