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

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(... Continued) Study or subgroup AL6 AQ+SP Risk Ratio Weight Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 0/147 2/156 9.7 % 0.21 [ 0.01, 4.38 ] Zongo 2005 BFA 37/245 11/233 45.2 % 3.20 [ 1.67, 6.12 ] Zongo 2007 BFA 36/178 11/171 45.0 % 3.14 [ 1.65, 5.97 ] Subtotal (95% CI) 570 560 100.0 % 2.88 [ 1.86, 4.47 ] Total events: 73 (AL6), 24 (AQ+SP) Heterogeneity: Chi 2 = 3.02, df = 2 (P = 0.22); I 2 =34% Test for overall effect: Z = 4.72 (P < 0.00001) 0.01 0.1 1 10 100 Favours AL6 Favours AQ+SP Analysis 11.2. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 2 Total Failure (P. falciparum) Day 28 PCR adjusted Study or subgroup AL6 AQ+SP Risk Ratio Risk Ratio 1 East Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Fanello 2004 RWA 8/218 51/209 0.15 [ 0.07, 0.31 ] Dorsey 2006 UGA 0/95 16/96 0.03 [ 0.00, 0.50 ] Subtotal (95% CI) 313 305 0.12 [ 0.06, 0.24 ] Total events: 8 (AL6), 67 (AQ+SP) Heterogeneity: Chi 2 = 1.27, df = 1 (P = 0.26); I 2 =21% Test for overall effect: Z = 5.93 (P < 0.00001) 2 West Africa Faye 2003 SEN 0/147 0/154 0.0 [ 0.0, 0.0 ] Zongo 2005 BFA 4/212 1/223 4.21 [ 0.47, 37.34 ] Zongo 2007 BFA 6/148 7/167 0.97 [ 0.33, 2.81 ] Subtotal (95% CI) 507 544 1.39 [ 0.55, 3.47 ] Total events: 10 (AL6), 8 (AQ+SP) Heterogeneity: Chi 2 = 1.43, df = 1 (P = 0.23); I 2 =30% Test for overall effect: Z = 0.70 (P = 0.49) 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 AQ+SP 184
Analysis 11.3. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 3 Total Failure (P. falciparum) Day 42 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 3 Total Failure (P. falciparum) Day 42 PCR unadjusted Study or subgroup AL6 AQ+SP Risk Ratio Weight Risk Ratio 1 West Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Zongo 2007 BFA 55/176 20/169 100.0 % 2.64 [ 1.66, 4.21 ] 0.2 0.5 1 2 5 Favours AL6 Favours AQ+SP Analysis 11.4. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 4 Total Failure (P. falciparum) Day 42 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 4 Total Failure (P. falciparum) Day 42 PCR adjusted Study or subgroup AL6 AQ+SP Risk Ratio Weight Risk Ratio 1 West Africa n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Zongo 2007 BFA 7/128 7/156 100.0 % 1.22 [ 0.44, 3.38 ] 0.5 0.7 1 1.5 2 Favours AL6 Favours AQ+SP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 185
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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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(... Continued) Study or subgroup D
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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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