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

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Analysis 6.7. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 7 Gametocyte carriage. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 6 Artesunate plus mefloquine vs Artemether-lumefantrine Outcome: 7 Gametocyte carriage Study or subgroup AS+MQ AL6 Risk Ratio Weight Risk Ratio 1 Gametocyte carriage day 0 n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 0/145 4/149 100.0 % 0.11 [ 0.01, 2.10 ] Subtotal (95% CI) 145 149 100.0 % 0.11 [ 0.01, 2.10 ] Total events: 0 (AS+MQ), 4 (AL6) Heterogeneity: not applicable Test for overall effect: Z = 1.46 (P = 0.14) 2 Gametocyte carriage day 3 Faye 2003 SEN 3/145 9/149 81.6 % 0.34 [ 0.09, 1.24 ] Van den Broek 2003a BGD 3/121 2/121 18.4 % 1.50 [ 0.26, 8.82 ] Subtotal (95% CI) 266 270 100.0 % 0.56 [ 0.21, 1.48 ] Total events: 6 (AS+MQ), 11 (AL6) Heterogeneity: Chi 2 = 1.75, df = 1 (P = 0.19); I 2 =43% Test for overall effect: Z = 1.17 (P = 0.24) 3 Gametocyte carriage day 7 Stohrer 2003 LAO 5/53 6/47 35.9 % 0.74 [ 0.24, 2.26 ] Van den Broek 2003a BGD 1/121 2/121 11.3 % 0.50 [ 0.05, 5.44 ] Faye 2003 SEN 0/145 9/149 52.9 % 0.05 [ 0.00, 0.92 ] Subtotal (95% CI) 319 317 100.0 % 0.35 [ 0.14, 0.85 ] Total events: 6 (AS+MQ), 17 (AL6) Heterogeneity: Chi 2 = 3.46, df = 2 (P = 0.18); I 2 =42% Test for overall effect: Z = 2.31 (P = 0.021) 4 Gametocyte carriage day 14 Faye 2003 SEN 0/145 4/149 89.9 % 0.11 [ 0.01, 2.10 ] Van den Broek 2003a BGD 1/121 0/121 10.1 % 3.00 [ 0.12, 72.92 ] Subtotal (95% CI) 266 270 100.0 % 0.41 [ 0.08, 2.10 ] Total events: 1 (AS+MQ), 4 (AL6) Heterogeneity: Chi 2 = 2.24, df = 1 (P = 0.13); I 2 =55% Test for overall effect: Z = 1.08 (P = 0.28) 0.001 0.01 0.1 1 10 100 1000 Favours ASMQ Favours AL Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 160
Analysis 6.8. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 8 Serious adverse events (including deaths). Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 6 Artesunate plus mefloquine vs Artemether-lumefantrine Outcome: 8 Serious adverse events (including deaths) Study or subgroup AS+MQ AL6 Risk Ratio Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Van Vugt 1998 THA 1/50 1/150 3.00 [ 0.19, 47.08 ] Lefevre 1999 THA 0/55 0/164 0.0 [ 0.0, 0.0 ] Hutagalung 2002 THA 0/245 0/245 0.0 [ 0.0, 0.0 ] Stohrer 2003 LAO 1/55 1/53 0.96 [ 0.06, 15.01 ] Mayxay 2003 LAO 3/110 0/110 7.00 [ 0.37, 133.94 ] Van den Broek 2003a BGD 0/121 0/121 0.0 [ 0.0, 0.0 ] Faye 2003 SEN 0/145 0/149 0.0 [ 0.0, 0.0 ] Total (95% CI) 781 992 2.96 [ 0.64, 13.76 ] Total events: 5 (AS+MQ), 2 (AL6) Heterogeneity: Chi 2 = 0.97, df = 2 (P = 0.62); I 2 =0.0% Test for overall effect: Z = 1.39 (P = 0.17) 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 161
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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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(Continued) Fofana 2005 Conference
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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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