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Sagara 2008 Sagara I, Diallo A, Kone M, Coulibaly M, Diawara SI, Guindo O, et al.A Randomized Trial of Artesunate-Mefloquine versus Artemether-Lumefantrine for Treatment of Uncomplicated Plasmodium falciparum Malaria in Mali. American Journal of Tropical Medicine and Hygiene 2008;79(5):655–661. Slutsker 1990 Slutsker LM, Khoromana CO, Payne D, Allen CR, Wirima JJ, Heymann DL, et al.Mefloquine therapy for Plasmodium falciparum malaria in children under5 years of age in Malawi: In vivo/in vitro efficacy and correlation of drug concentration with parasitological outcome. Bulletin of the World Health Organisation 1990;68(1):53–59. Targett 2001 Targett G, Drakeley C, Jawara M, von Seidlein L, Coleman R, Deen J, et al.Artesunate reduces but does not prevent posttreatment transmission of Plasmodium falciparum to Anopheles gambiae. Journal of Infectious Diseases 2001;183(8):1254–9. Vugt 1999 Vugt MV, Wilairatana P, Gemperli B, Gathmann I, Phaipun L, Brockman A, et al.Efficacy of six doses of artemether-lumefantrine (benflumetol) in multidrug-resistant Plasmodium falciparum malaria. American Journal of Tropical Medicine and Hygiene 1999; 60(6):936–42. White 1996 White NJ, Olliaro PL. Strategies for the prevention of antimalarial drug resistance: rationale for combination chemotherapy for malaria. Parasitology Today 1996;12(10):399–401. Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. White 1999 White NJ, Nosten F, Looareesuwan S, Watkins WM, Marsh K, Snow RW, et al.Averting a malaria disaster. The Lancet 1999;353 (9168):1965–7. White 2002 White NJ. The assessment of antimalarial drug efficacy. Trends in Parasitology 2002;18(10):458–64. WHO 2003 Bloland PB. Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparum malaria [WHO/HTM/ RBM/2003.50]. Geneva: World Health Organization, 2003. WHO 2006 World Health Organization. Roll Back Malaria Dept. Guidelines for the treatment of malaria [WHO/HTM/MAL/2006.1108]. Geneva: World Health Organization, 2006. WHO 2007 World Health Organization. Malaria [Fact sheet no. 94]. www.who.int/mediacentre/factsheets/fs094/en/index.html May 2007 (accessed 1 July 2008). WHO 2008a World Health Organization. Global malaria control and elimination: report of a meeting on containment of artemisinin tolerance, 19 January 2008, Geneva, Switzerland. Geneva: World Health Organization, 2008. WHO 2008b WHO Global Malaria Programme. World Malaria Report: 2008. Geneva: World Health Organization, 2008. ∗ Indicates the major publication for the study 36
C H A R A C T E R I S T I C S O F S T U D I E S Characteristics of included studies [ordered by study ID] Adjei 2006 GHA Methods Trial design: A single blind randomized controlled trial Follow up: Clinical and laboratory assessment on days 0, 1, 2, 3, 7, 14, 28 and then monthly for 1 year Adverse event monitoring: Assessed at each visit up to 1 year using open questions about side effects, behavioural and developmental concerns. Neurological examination at each visit. Audiometry assessment on days 0, 3, 7, 28, and 1 year. WBC, aminotransferase and total bilirubin at days 0, 3, 7, 14, and 28. Participants Number: 227 randomized Inclusion criteria: Age 6 months to 14 yrs, axillary temp > 37.5 ºC, signs and symptoms of uncomplicated malaria, P. falciparum mono-infection 2000 to 200,000/µl, willingness to comply with the follow up, informed consent Exclusion criteria: Signs or symptoms of severe malaria, chronic malnutrition or other severe disease, known intolerance or allergy to study meds, reported treatment with any of the study drugs during preceding month Interventions 1. Artemether-lumefantrine, fixed dose combination, 20 mg/120 mg tablets (Coartem: Novartis) • 5 to 14 kg 1 tablet twice daily for 3 days • 15 to 24 kg 2 tablets twice daily for 3 days • 25 to 34 kg 3 tablets twice daily for 3 days • > 35 kg 4 tablets twice daily for 3 days 2. Artesunate plus amodiaquine, loose combination (Plasmotrim: Mepha, Camoquine: Pfizer) • AS 4 mg/kg once daily for 3 days • AQ 10 mg/kg once daily for 3 days Only the first dose each day was supervized Outcomes 1. ACPR at day 28, PCR adjusted and PCR unadjusted 2. Adverse events including neurological, biochemical, and audiological events Not included in this review: 1. Fever clearance 2. Parasite clearance 3. Further episodes of symptomatic malaria in 1 year Notes Country: Ghana Setting: Urban primary health facilities Transmission: Not described Resistance: AQ Dates: Oct 2004 to Dec 2006 Funding: Danish Council for Development Research, Global Fund for AIDS, TB and Malaria through the National Malaria Control Programme Risk of bias Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 37
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D A T A A N D A N A L Y S E S Compa
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Analysis 20.1. Comparison 20 How do
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PCR = polymerase chain reaction PCV
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(Continued) justed Vivax efficacy:
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1 Dorsey 2006 UGA; Faye 2003 SEN; K
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