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

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(... Continued) Study or subgroup AL6 AS+AQ Risk Ratio Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Dorsey 2006 UGA 3/103 9/111 0.36 [ 0.10, 1.29 ] Kobbe 2007 GHA 18/109 20/108 0.89 [ 0.50, 1.59 ] Subtotal (95% CI) 984 1212 1.01 [ 0.78, 1.31 ] Total events: 96 (AL6), 102 (AS+AQ) Heterogeneity: Chi 2 = 6.19, df = 7 (P = 0.52); I 2 =0.0% Test for overall effect: Z = 0.05 (P = 0.96) 6 Total Failure Day 28 PCR adjusted (losses to follow up included as successes) Faye 2003 SEN 0/149 0/360 0.0 [ 0.0, 0.0 ] Guthmann 2004 AGO 0/65 0/69 0.0 [ 0.0, 0.0 ] Falade 2005 NGA 0/66 0/66 0.0 [ 0.0, 0.0 ] Bukirwa 2005 UGA 5/204 1/204 5.00 [ 0.59, 42.42 ] Owusu-Agyei 2006 GHA 21/177 10/178 2.11 [ 1.02, 4.35 ] Dorsey 2006 UGA 0/103 3/111 0.15 [ 0.01, 2.94 ] Adjei 2006 GHA 4/111 2/116 2.09 [ 0.39, 11.18 ] Kobbe 2007 GHA 12/109 8/108 1.49 [ 0.63, 3.49 ] Subtotal (95% CI) 984 1212 1.75 [ 1.08, 2.83 ] Total events: 42 (AL6), 24 (AS+AQ) Heterogeneity: Chi 2 = 3.98, df = 4 (P = 0.41); I 2 =0.0% Test for overall effect: Z = 2.28 (P = 0.023) 0.001 0.01 0.1 1 10 100 1000 Favours AL6 Favours AS+AQ Analysis 10.1. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 42 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 1 Total Failure (P. falciparum) Day 42 PCR unadjusted Study or subgroup AL6 AS+SP Risk Ratio Weight Risk Ratio 1 Oceania n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Karunajeewa 2007 PNG 40/109 41/108 100.0 % 0.97 [ 0.68, 1.36 ] 0.01 0.1 1 10 100 Favours AL6 Favours AS+SP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 176
Analysis 10.2. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 42 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 2 Total Failure (P. falciparum) Day 42 PCR adjusted Study or subgroup AL6 AS+SP Risk Ratio Weight Risk Ratio 1 Oceania n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Karunajeewa 2007 PNG 5/74 17/84 100.0 % 0.33 [ 0.13, 0.86 ] 0.01 0.1 1 10 100 Favours AL6 Favours AS+SP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 177
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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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Comparison 10. Artemether-lumefantr
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Comparison 12. Artesunate plus amod
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5.2 DHA-P 3 doses 3 1116 Risk Ratio
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Comparison 21. How does Artesunate
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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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