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

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(... Continued) Study or subgroup AS+MQ AQ+SP Risk Ratio Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Subtotal (95% CI) 145 161 0.03 [ 0.00, 0.47 ] Total events: 0 (AS+MQ), 19 (AQ+SP) Heterogeneity: not applicable Test for overall effect: Z = 2.49 (P = 0.013) 4 Gametocyte carriage day 14 Faye 2003 SEN 0/145 0/161 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 145 161 0.0 [ 0.0, 0.0 ] Total events: 0 (AS+MQ), 0 (AQ+SP) Heterogeneity: not applicable Test for overall effect: Z = 0.0 (P < 0.00001) 0.005 0.1 1 10 200 Favours AS+MQ Favours AQ+SP Analysis 9.1. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 1 Total Failure (P. falciparum) Day 28 PCR unadjusted Study or subgroup AL6 AS+AQ Risk Ratio Risk Ratio 1 East Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Mutabingwa 2004 TZA 103/485 193/472 0.52 [ 0.42, 0.64 ] Bukirwa 2005 UGA 102/202 133/201 0.76 [ 0.64, 0.90 ] Dorsey 2006 UGA 5/100 7/105 0.75 [ 0.25, 2.29 ] 2 West Africa Faye 2003 SEN 0/147 9/349 0.12 [ 0.01, 2.12 ] Falade 2005 NGA 3/62 5/61 0.59 [ 0.15, 2.36 ] Adjei 2006 GHA 6/103 5/107 1.25 [ 0.39, 3.96 ] Owusu-Agyei 2006 GHA 42/152 22/151 1.90 [ 1.19, 3.02 ] Kobbe 2007 GHA 23/103 15/96 1.43 [ 0.79, 2.57 ] 3 South/Central Africa Guthmann 2004 AGO 2/61 4/64 0.52 [ 0.10, 2.76 ] 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 AL6 Favours AS+AQ 166
Analysis 9.2. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 2 Total Failure (P. falciparum) Day 28 PCR adjusted Study or subgroup AL6 AS+AQ Risk Ratio Risk Ratio 1 East Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Bukirwa 2005 UGA 2/102 0/68 3.35 [ 0.16, 68.71 ] Dorsey 2006 UGA 0/95 2/100 0.21 [ 0.01, 4.33 ] Subtotal (95% CI) 197 168 0.83 [ 0.15, 4.59 ] Total events: 2 (AL6), 2 (AS+AQ) Heterogeneity: Chi 2 = 1.61, df = 1 (P = 0.20); I 2 =38% Test for overall effect: Z = 0.21 (P = 0.83) 2 West Africa Faye 2003 SEN 0/147 0/340 0.0 [ 0.0, 0.0 ] Falade 2005 NGA 0/59 0/56 0.0 [ 0.0, 0.0 ] Owusu-Agyei 2006 GHA 12/122 7/136 1.91 [ 0.78, 4.70 ] Adjei 2006 GHA 4/101 2/104 2.06 [ 0.39, 11.00 ] Kobbe 2007 GHA 12/92 7/88 1.64 [ 0.68, 3.97 ] Subtotal (95% CI) 521 724 1.81 [ 1.00, 3.26 ] Total events: 28 (AL6), 16 (AS+AQ) Heterogeneity: Chi 2 = 0.08, df = 2 (P = 0.96); I 2 =0.0% Test for overall effect: Z = 1.96 (P = 0.050) 3 South/Central Africa Guthmann 2004 AGO 0/59 0/60 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 59 60 0.0 [ 0.0, 0.0 ] Total events: 0 (AL6), 0 (AS+AQ) Heterogeneity: not applicable Test for overall effect: Z = 0.0 (P < 0.00001) Total (95% CI) 777 952 1.65 [ 0.95, 2.87 ] Total events: 30 (AL6), 18 (AS+AQ) Heterogeneity: Chi 2 = 2.16, df = 4 (P = 0.71); I 2 =0.0% Test for overall effect: Z = 1.77 (P = 0.077) 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 AL6 Favours AS+AQ 167
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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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2.2 Asia 1 317 Risk Ratio (M-H, Fix
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Comparison 5. Dihydroartemisinin-pi
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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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