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

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Analysis 5.6. Comparison 5 Dihydroartemisinin-piperaquine vs Amodiaquine plus sulfadoxinepyrimethamine, Outcome 6 Anaemia. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 5 Dihydroartemisinin-piperaquine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 6 Anaemia Study or subgroup DHA-P AQ+SP Mean Difference Weight Mean Difference 1 Mean haemoglobin (g/dl) at baseline N Mean(SD) N Mean(SD) IV,Fixed,95% CI IV,Fixed,95% CI Zongo 2007 BFA 187 10.1 (2.4) 184 10.3 (2.3) 100.0 % -0.20 [ -0.68, 0.28 ] Subtotal (95% CI) 187 184 100.0 % -0.20 [ -0.68, 0.28 ] Heterogeneity: not applicable Test for overall effect: Z = 0.82 (P = 0.41) 2 Mean haemoglobin (g/dl) at day 42 or last day of follow up Zongo 2007 BFA 187 11.6 (1.6) 184 11.8 (1.4) 100.0 % -0.20 [ -0.51, 0.11 ] Subtotal (95% CI) 187 184 100.0 % -0.20 [ -0.51, 0.11 ] Heterogeneity: not applicable Test for overall effect: Z = 1.28 (P = 0.20) 3 Mean packed cell volume at baseline Karema 2004 RWA 252 31.5 (4.9) 258 31.5 (5.3) 100.0 % 0.0 [ -0.89, 0.89 ] Subtotal (95% CI) 252 258 100.0 % 0.0 [ -0.89, 0.89 ] Heterogeneity: not applicable Test for overall effect: Z = 0.0 (P = 1.0) 4 Mean packed cell volume at day 14 Karema 2004 RWA 252 33.4 (3.6) 258 34.5 (3.7) 100.0 % -1.10 [ -1.73, -0.47 ] Subtotal (95% CI) 252 258 100.0 % -1.10 [ -1.73, -0.47 ] Heterogeneity: not applicable Test for overall effect: Z = 3.40 (P = 0.00067) Test for subgroup differences: Chi 2 = 7.14, df = 3 (P = 0.07), I 2 =58% Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. -2 -1 0 1 2 Favours AQ+SP Favours DHA-P 154
Analysis 5.7. Comparison 5 Dihydroartemisinin-piperaquine vs Amodiaquine plus sulfadoxinepyrimethamine, Outcome 7 Early vomiting. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 5 Dihydroartemisinin-piperaquine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 7 Early vomiting Study or subgroup DHA-P AQ+SP Risk Ratio Weight Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Zongo 2007 BFA 7/196 2/187 100.0 % 3.34 [ 0.70, 15.87 ] Total (95% CI) 196 187 100.0 % 3.34 [ 0.70, 15.87 ] Total events: 7 (DHA-P), 2 (AQ+SP) Heterogeneity: not applicable Test for overall effect: Z = 1.52 (P = 0.13) 0.1 0.2 0.5 1 2 5 10 Favours DHA-P Favours AQ+SP Analysis 6.1. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 1 Total Failure (P. falciparum) Day 42 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 6 Artesunate plus mefloquine vs Artemether-lumefantrine Outcome: 1 Total Failure (P. falciparum) Day 42 PCR unadjusted 1 Asia Study or subgroup AS+MQ AL6 Risk Ratio Weight Risk Ratio n/N n/N M-H,Random,95% CI M-H,Random,95% CI Hutagalung 2002 THA 24/227 27/225 35.1 % 0.88 [ 0.52, 1.48 ] Stohrer 2003 LAO 8/53 13/47 25.7 % 0.55 [ 0.25, 1.20 ] Mayxay 2003 LAO 2/108 14/107 12.0 % 0.14 [ 0.03, 0.61 ] Van den Broek 2003a BGD 9/114 20/119 27.1 % 0.47 [ 0.22, 0.99 ] 0.01 0.1 1 10 100 Favours ASMQ Favours AL Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 155
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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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Van Vugt 1998 THA Methods Trial des
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Yeka 2004 UGA (Continued) Risk of b
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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
Page 117 and 118: 2.2 Asia 1 317 Risk Ratio (M-H, Fix
Page 119 and 120: Comparison 5. Dihydroartemisinin-pi
Page 121 and 122: Comparison 8. Artesunate plus meflo
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Page 125 and 126: Comparison 12. Artesunate plus amod
Page 127 and 128: 5.2 DHA-P 3 doses 3 1116 Risk Ratio
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Page 139 and 140: Analysis 1.12. Comparison 1 Dihydro
Page 141 and 142: (... Continued) Study or subgroup D
Page 159: Analysis 5.4. Comparison 5 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
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Page 183 and 184: Analysis 10.2. Comparison 10 Arteme
Page 197 and 198: Analysis 12.2. Comparison 12 Artesu
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Analysis 15.4. Comparison 15 Dihydr
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Analysis 15.6. Comparison 15 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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