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

(Continued)
Vivax efficacy: P.
vivax parasitaemia
by day 63
Transmission
potential: Gametocytedevelopment
(in those negative
at baseline)
Harms: Serious adverse
events (including
deaths)
Harms: Early vomiting
180 per 1000 200 per 1000
(164 to 241)
9 per 1000 28 per 1000
(10 to 79)
7 per 1000 6 per 1000
(3 to 15)
88 per 1000 79 per 1000
(61 to 102)
RR 1.11
(0.91 to 1.34)
RR 3.06
(1.13 to 8.83)
RR 0.9
(0.38 to 2.15)
RR 0.90
(0.69 to 1.16)
1661
(4)
1234
(3)
2617
(8)
2473
(7)
⊕⊕⊕
moderate
4,12,13,14,15
⊕⊕⊕⊕
high 4,11,13,16
⊕⊕
low 4,10,13,17
⊕⊕
low 4,13,18,19
*The assumed risk is the mean risk from the studies included in this review, calculated as the number of patients in the control
groups with the event divided by the total number of patients in control groups. The corresponding risk (and its 95% confidence
interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; RR: risk ratio
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change
the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to
change the estimate.
Very low quality: We are very uncertain about the estimate.
Footnotes
1 Data on treatment failure at days 42 and 28 were also available and no differences between the two drugs were shown.
2 Ashley 2003b THA, Ashley 2004 THA and Janssens 2003 KHM.
3 No serious limitations: Allocation concealment was judged to be at ’low risk of bias’ in two trials and ’unclear’ in one. Sensitivity
analysis only including trials with adequate concealment did not substantially change the result. Laboratory staff were blinded in two
of the trials.
4 No serious inconsistency: Heterogeneity was low.
5 No serious indirectness: Trials were conducted in Asia (Thailand and Cambodia) in areas of low and unstable transmission. Children
age < one year and pregnant or lactating women were excluded.
6 No serious imprecision: The 95% CI of the pooled estimate includes appreciable benefit with DHA-P over AS+MQ and no appreciable
benefit.
7 Grande 2005 PER.
8 No serious limitations: Allocation concealment was assessed as ’low risk of bias’. No blinding was described in this trial.
Artemisinin-based combination therapy for treating uncomplicated malaria (Review)
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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