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

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Analysis 9.3. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 3 Gametocyte development. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 3 Gametocyte development Study or subgroup AL6 AS+AQ Risk Ratio Weight Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Bukirwa 2005 UGA 8/162 21/143 100.0 % 0.34 [ 0.15, 0.74 ] Total (95% CI) 162 143 100.0 % 0.34 [ 0.15, 0.74 ] Total events: 8 (AL6), 21 (AS+AQ) Heterogeneity: not applicable Test for overall effect: Z = 2.73 (P = 0.0063) 0.2 0.5 1 2 5 Favours AL6 Favours AS+AQ Analysis 9.4. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 4 Gametocyte carriage. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 4 Gametocyte carriage Study or subgroup AL6 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 4/149 0/360 21.66 [ 1.17, 399.81 ] Owusu-Agyei 2006 GHA 11/177 10/178 1.11 [ 0.48, 2.54 ] Dorsey 2006 UGA 11/103 16/111 0.74 [ 0.36, 1.52 ] 2 Gametocyte carriage day 3 Faye 2003 SEN 9/149 0/360 45.73 [ 2.68, 780.64 ] 3 Gametocyte carriage day 7 Faye 2003 SEN 9/149 0/360 45.73 [ 2.68, 780.64 ] Dorsey 2006 UGA 5/102 11/111 0.49 [ 0.18, 1.38 ] Owusu-Agyei 2006 GHA 0/152 3/151 0.14 [ 0.01, 2.72 ] Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.001 0.01 0.1 1 10 100 1000 Favours AL6 Favours AS+AQ (Continued ...) 168
(... Continued) Study or subgroup AL6 AS+AQ Risk Ratio Risk Ratio 4 Gametocyte carriage day 14 n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 4/149 0/360 21.66 [ 1.17, 399.81 ] Dorsey 2006 UGA 2/100 7/109 0.31 [ 0.07, 1.46 ] 0.001 0.01 0.1 1 10 100 1000 Favours AL6 Favours AS+AQ Analysis 9.5. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 5 Anaemia. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 5 Anaemia Study or subgroup AL6 AS+AQ Mean Difference Mean Difference 1 Mean haemoglobin (g/dl) at baseline N Mean(SD) N Mean(SD) IV,Fixed,95% CI IV,Fixed,95% CI Bukirwa 2005 UGA 202 10.3 (1.73) 201 10.3 (1.74) 0.0 [ -0.34, 0.34 ] Dorsey 2006 UGA 202 11.5 (1.2) 232 11.5 (1.4) 0.0 [ -0.24, 0.24 ] Owusu-Agyei 2006 GHA 152 9.2 (1.4) 151 9 (1.3) 0.20 [ -0.10, 0.50 ] Kobbe 2007 GHA 123 9.6 (1.7) 123 9.9 (1.9) -0.30 [ -0.75, 0.15 ] 2 Mean haemoglobin (g/dl) at Day 28 Owusu-Agyei 2006 GHA 152 10 (1.6) 151 9.9 (1.7) 0.10 [ -0.27, 0.47 ] 3 Mean change in haemoglobin (g/dl) from baseline to Day 28 Bukirwa 2005 UGA 202 1.39 (1.76) 201 1.35 (1.71) 0.04 [ -0.30, 0.38 ] 4 Mean haematocrit at baseline Falade 2005 NGA 66 30 (5.05) 66 30.4 (4.79) -0.40 [ -2.08, 1.28 ] 5 Mean haematocrit at Day 28 Falade 2005 NGA 66 33.4 (3.45) 66 33 (3.79) 0.40 [ -0.84, 1.64 ] 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 AS+AQ Favours AL6 169
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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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Comparison 8. Artesunate plus meflo
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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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