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

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Analysis 6.9. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 9 Early vomiting. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 6 Artesunate plus mefloquine vs Artemether-lumefantrine Outcome: 9 Early vomiting 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 5/50 4/150 3.75 [ 1.05, 13.42 ] Lefevre 1999 THA 1/55 2/164 1.49 [ 0.14, 16.12 ] Hutagalung 2002 THA 2/245 5/245 0.40 [ 0.08, 2.04 ] Mayxay 2003 LAO 3/110 6/110 0.50 [ 0.13, 1.95 ] Stohrer 2003 LAO 0/55 0/53 0.0 [ 0.0, 0.0 ] Van den Broek 2003a BGD 1/121 0/121 3.00 [ 0.12, 72.92 ] Total (95% CI) 636 843 1.07 [ 0.55, 2.08 ] Total events: 12 (AS+MQ), 17 (AL6) Heterogeneity: Chi 2 = 6.79, df = 4 (P = 0.15); I 2 =41% Test for overall effect: Z = 0.19 (P = 0.85) 0.01 0.1 1 10 100 Favours ASMQ Favours AL Analysis 7.1. Comparison 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine Outcome: 1 Total Failure (P. falciparum) Day 28 PCR unadjusted Study or subgroup AS+MQ AS+AQ Risk Ratio Weight Risk Ratio 1 Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 2/144 9/349 100.0 % 0.54 [ 0.12, 2.46 ] 0.01 0.1 1 10 100 Favours AS+MQ Favours AS+AQ Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 162
Analysis 7.2. Comparison 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine Outcome: 2 Total Failure (P. falciparum) Day 28 PCR adjusted Study or subgroup AS+MQ AS+AQ Risk Ratio Risk Ratio 1 Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 0/142 0/340 0.0 [ 0.0, 0.0 ] 0.01 0.1 1 10 100 Favours AS+MQ Favours AS+AQ Analysis 7.3. Comparison 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine, Outcome 3 Gametocyte carriage. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine Outcome: 3 Gametocyte carriage Study or subgroup AS+MQ AS+AQ Risk Ratio 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 0/360 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 145 360 0.0 [ 0.0, 0.0 ] Total events: 0 (AS+MQ), 0 (AS+AQ) Heterogeneity: not applicable Test for overall effect: Z = 0.0 (P < 0.00001) 2 Gametocyte carriage day 3 Faye 2003 SEN 3/145 0/360 17.31 [ 0.90, 332.99 ] Subtotal (95% CI) 145 360 17.31 [ 0.90, 332.99 ] Total events: 3 (AS+MQ), 0 (AS+AQ) Heterogeneity: not applicable Test for overall effect: Z = 1.89 (P = 0.059) 3 Gametocyte carriage day 7 Faye 2003 SEN 0/145 0/360 0.0 [ 0.0, 0.0 ] 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 AS+MQ Favours AS+AQ (Continued ...) 163
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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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D A T A A N D A N A L Y S E S Compa
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Page 165 and 166: Analysis 6.6. Comparison 6 Artesuna
Page 167: Analysis 6.8. Comparison 6 Artesuna
Page 171 and 172: Analysis 8.2. Comparison 8 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 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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