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

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Analysis 12.3. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 3 Gametocyte carriage. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 3 Gametocyte carriage Study or subgroup AS+AQ AS+SP Risk Ratio Weight Risk Ratio 1 Gametocyte carriage day 0 n/N n/N M-H,Random,95% CI M-H,Random,95% CI Hamour 2003 SDN 4/80 4/81 8.7 % 1.01 [ 0.26, 3.91 ] Swarthout 2004 ZAR 11/90 12/89 27.1 % 0.91 [ 0.42, 1.95 ] Van den Broek 2004 ZAR 23/101 24/91 64.2 % 0.86 [ 0.53, 1.42 ] Subtotal (95% CI) 271 261 100.0 % 0.89 [ 0.60, 1.32 ] Total events: 38 (AS+AQ), 40 (AS+SP) Heterogeneity: Tau 2 = 0.0; Chi 2 = 0.05, df = 2 (P = 0.97); I 2 =0.0% Test for overall effect: Z = 0.59 (P = 0.56) 2 Gametocyte carriage day 3 Van den Broek 2004 ZAR 36/99 36/88 75.0 % 0.89 [ 0.62, 1.28 ] Swarthout 2004 ZAR 16/89 16/87 25.0 % 0.98 [ 0.52, 1.83 ] Subtotal (95% CI) 188 175 100.0 % 0.91 [ 0.67, 1.25 ] Total events: 52 (AS+AQ), 52 (AS+SP) Heterogeneity: Tau 2 = 0.0; Chi 2 = 0.07, df = 1 (P = 0.80); I 2 =0.0% Test for overall effect: Z = 0.59 (P = 0.56) 3 Gametocyte carriage day 7 Van den Broek 2004 ZAR 30/98 31/89 78.9 % 0.88 [ 0.58, 1.33 ] Swarthout 2004 ZAR 13/87 9/89 21.1 % 1.48 [ 0.67, 3.28 ] Subtotal (95% CI) 185 178 100.0 % 1.02 [ 0.64, 1.61 ] Total events: 43 (AS+AQ), 40 (AS+SP) Heterogeneity: Tau 2 = 0.03; Chi 2 = 1.31, df = 1 (P = 0.25); I 2 =24% Test for overall effect: Z = 0.07 (P = 0.95) 4 Gametocyte carriage day 14 Hamour 2003 SDN 3/80 4/79 16.0 % 0.74 [ 0.17, 3.20 ] Swarthout 2004 ZAR 7/87 1/86 8.0 % 6.92 [ 0.87, 55.06 ] Van den Broek 2004 ZAR 12/99 18/89 76.0 % 0.60 [ 0.31, 1.17 ] Subtotal (95% CI) 266 254 100.0 % 1.08 [ 0.32, 3.73 ] Total events: 22 (AS+AQ), 23 (AS+SP) Heterogeneity: Tau 2 = 0.72; Chi 2 = 5.14, df = 2 (P = 0.08); I 2 =61% Test for overall effect: Z = 0.13 (P = 0.90) 0.01 0.1 1 10 100 Favours ASAQ Favours ASSP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 192
Analysis 12.4. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 4 Proportion of participants with anaemia. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine Outcome: 4 Proportion of participants with anaemia Study or subgroup AS+AQ AS+SP Risk Ratio Weight Risk Ratio 1 At baseline n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Guthmann 2003 AGO 80/97 81/90 45.1 % 0.92 [ 0.82, 1.03 ] Kayentao 2006 MLI 93/133 102/132 54.9 % 0.90 [ 0.78, 1.05 ] Subtotal (95% CI) 230 222 100.0 % 0.91 [ 0.83, 1.00 ] Total events: 173 (AS+AQ), 183 (AS+SP) Heterogeneity: Chi 2 = 0.02, df = 1 (P = 0.89); I 2 =0.0% Test for overall effect: Z = 1.95 (P = 0.051) 2 At Day 28 Guthmann 2003 AGO 33/84 31/84 28.4 % 1.06 [ 0.72, 1.57 ] Kayentao 2006 MLI 71/131 78/130 71.6 % 0.90 [ 0.73, 1.12 ] Subtotal (95% CI) 215 214 100.0 % 0.95 [ 0.79, 1.14 ] Total events: 104 (AS+AQ), 109 (AS+SP) Heterogeneity: Chi 2 = 0.55, df = 1 (P = 0.46); I 2 =0.0% Test for overall effect: Z = 0.55 (P = 0.58) 0.5 0.7 1 1.5 2 Favours AS+AQ Favours AS+SP Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 193
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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) 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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