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

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Analysis 6.5. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 5 P. vivax parasitaemia. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 6 Artesunate plus mefloquine vs Artemether-lumefantrine Outcome: 5 P. vivax parasitaemia Study or subgroup AS+MQ 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 Lefevre 1999 THA 7/55 16/164 1.30 [ 0.57, 3.00 ] Hutagalung 2002 THA 0/245 0/245 0.0 [ 0.0, 0.0 ] Van den Broek 2003a BGD 0/121 0/121 0.0 [ 0.0, 0.0 ] Stohrer 2003 LAO 0/55 0/53 0.0 [ 0.0, 0.0 ] Mayxay 2003 LAO 0/110 0/110 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 586 693 1.30 [ 0.57, 3.00 ] Total events: 7 (AS+MQ), 16 (AL6) Heterogeneity: Chi 2 = 0.0, df = 0 (P = 1.00); I 2 =0.0% Test for overall effect: Z = 0.62 (P = 0.53) 2 P. vivax parasitaemia by day 28 Lefevre 1999 THA 0/53 6/155 0.22 [ 0.01, 3.88 ] Subtotal (95% CI) 53 155 0.22 [ 0.01, 3.88 ] Total events: 0 (AS+MQ), 6 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 1.03 (P = 0.30) 3 P. vivax parasitaemia by day 42 Hutagalung 2002 THA 29/227 90/225 0.32 [ 0.22, 0.47 ] Mayxay 2003 LAO 0/108 5/107 0.09 [ 0.01, 1.61 ] Van den Broek 2003a BGD 6/114 26/119 0.24 [ 0.10, 0.56 ] Stohrer 2003 LAO 1/54 2/49 0.45 [ 0.04, 4.85 ] Subtotal (95% CI) 503 500 0.30 [ 0.21, 0.41 ] Total events: 36 (AS+MQ), 123 (AL6) Heterogeneity: Chi 2 = 1.17, df = 3 (P = 0.76); I 2 =0.0% Test for overall effect: Z = 7.07 (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 ASMQ Favours AL 158
Analysis 6.6. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 6 Gametocyte development (in those negative at baseline). Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 6 Artesunate plus mefloquine vs Artemether-lumefantrine Outcome: 6 Gametocyte development (in those negative at baseline) Study or subgroup AS+MQ AL6 Risk Ratio Weight Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Lefevre 1999 THA 2/45 1/138 6.6 % 6.13 [ 0.57, 66.06 ] Hutagalung 2002 THA 3/240 3/241 39.9 % 1.00 [ 0.20, 4.93 ] Mayxay 2003 LAO 4/110 4/109 53.5 % 0.99 [ 0.25, 3.86 ] Total (95% CI) 395 488 100.0 % 1.33 [ 0.54, 3.28 ] Total events: 9 (AS+MQ), 8 (AL6) Heterogeneity: Chi 2 = 1.89, df = 2 (P = 0.39); I 2 =0.0% Test for overall effect: Z = 0.63 (P = 0.53) 0.005 0.1 1 10 200 Favours ASMQ Favours AL Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 159
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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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Yeka 2007 UGA (Continued) Free of o
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Zongo 2007 BFA (Continued) Novartis
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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 163: (... Continued) Study or subgroup A
Page 167 and 168: Analysis 6.8. Comparison 6 Artesuna
Page 173 and 174: Analysis 9.2. Comparison 9 Artemeth
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Page 177 and 178: Analysis 9.8. Comparison 9 Artemeth
Page 183 and 184: Analysis 10.2. Comparison 10 Arteme
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Page 207 and 208: 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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