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

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Analysis 11.7. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 7 Anaemia. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 7 Anaemia Study or subgroup AL6 AQ+SP 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 Zongo 2005 BFA 261 9.3 (2.3) 260 9.9 (2.3) -0.60 [ -0.99, -0.21 ] Zongo 2007 BFA 188 10.2 (2) 184 10.3 (2.3) -0.10 [ -0.54, 0.34 ] 2 Mean change in haemoglobin (g/dl) from baseline to Day 28 Zongo 2005 BFA 261 1.18 (0.19) 260 1.01 (0.2) 0.17 [ 0.14, 0.20 ] 3 Mean haemoglobin (g/dl) at Day 42 or last day of follow up. Zongo 2007 BFA 188 11.3 (1.6) 184 11.8 (1.4) -0.50 [ -0.81, -0.19 ] -1 -0.5 0 0.5 1 Favours AS+AQ Favours AL6 Analysis 11.8. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 8 Serious adverse events (including deaths). Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 8 Serious adverse events (including deaths) Study or subgroup AL6 AQ+SP Risk Ratio Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 0/149 0/161 0.0 [ 0.0, 0.0 ] Mutabingwa 2004 TZA 1/519 1/507 0.98 [ 0.06, 15.58 ] Zongo 2005 BFA 1/261 1/260 1.00 [ 0.06, 15.84 ] Dorsey 2006 UGA 14/202 16/253 1.10 [ 0.55, 2.19 ] Zongo 2007 BFA 0/188 0/184 0.0 [ 0.0, 0.0 ] Total (95% CI) 1319 1365 1.08 [ 0.56, 2.08 ] Total events: 16 (AL6), 18 (AQ+SP) Heterogeneity: Chi 2 = 0.01, df = 2 (P = 1.00); I 2 =0.0% Test for overall effect: Z = 0.24 (P = 0.81) Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.01 0.1 1 10 100 Favours AL6 Favours AQ+SP 188
Analysis 11.9. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 9 Early vomiting. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine Outcome: 9 Early vomiting 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 Zongo 2005 BFA 7/261 5/260 71.2 % 1.39 [ 0.45, 4.34 ] Zongo 2007 BFA 3/188 2/184 28.8 % 1.47 [ 0.25, 8.68 ] Total (95% CI) 449 444 100.0 % 1.42 [ 0.54, 3.68 ] Total events: 10 (AL6), 7 (AQ+SP) Heterogeneity: Chi 2 = 0.00, df = 1 (P = 0.96); I 2 =0.0% Test for overall effect: Z = 0.71 (P = 0.48) 0.01 0.1 1 10 100 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. 189
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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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Analysis 1.12. Comparison 1 Dihydro
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(... Continued) Study or subgroup D
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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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