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

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Ashley 2005 THA (Continued)<br />

Exclusion criteria: Pregnancy or lactation, signs or symptoms of severe malaria, > 4%<br />

of red blood cells parasitized, treatment with mefloquine in the previous 60 days, contraindication<br />

to mefloquine<br />

Interventions 1. Artesunate plus mefloquine, fixed-dose <strong>combination</strong>, adult tablets 100 mg/220 mg,<br />

paediatric tablets 25 mg/55 mg (Far-Manguinhos)<br />

• 5 to 8 kg 1 paediatric tablet per day<br />

• 9 to 17 kg 2 paediatric tablets per day<br />

• 18 to 29 kg 1 adult tablet per day<br />

• > 30 kg 2 adult tablets per day<br />

2. Artesunate plus mefloquine, loose <strong>combination</strong>, (Arsumax: Sanofi-Synthelabo, Lariam:<br />

Roche)<br />

• AS 4 mg/kg once daily <strong>for</strong> 3 days<br />

• MQ 15 mg/kg on day 1 and 10 mg/kg on day 2<br />

All doses supervized<br />

Outcomes 1. Cure rate at day 63, PCR adjusted and unadjusted<br />

2. P. vivax during follow up, and median time to reappearance<br />

3. Gametocyte development during follow up<br />

4. Mean haematocrit during follow up<br />

5. Adverse events<br />

Not included in this review:<br />

1. Fever clearance<br />

2. Parasite clearance<br />

Notes Country: Thailand<br />

Setting: 6 clinics on the Thai-Myanmar border<br />

Transmission: Unstable low and seasonal transmission<br />

Resistance: Multiple-drug resistance<br />

Dates: Nov 2004 to Jun 2005<br />

Funding: DNDi, European Union International Co-operation programme, Médecins<br />

sans Frontières, WHO/TDR, Wellcome Trust of Great Britain<br />

Risk of bias<br />

Item Authors’ judgement Description<br />

Adequate sequence generation? Yes ’Randomised in blocks of 10 by a statistician<br />

using a computer-generated randomisation’<br />

Allocation concealment? Yes ’<strong>The</strong> treatment allocation was concealed in<br />

numbered, sealed envelopes...opened only<br />

after enrolment in the study’<br />

Blinding?<br />

All outcomes<br />

<strong>Artemisinin</strong>-<strong>based</strong> <strong>combination</strong> <strong>therapy</strong> <strong>for</strong> treating uncomplicated malaria (Review)<br />

Copyright © 2009 <strong>The</strong> <strong>Cochrane</strong> Collaboration. Published by John Wiley & Sons, Ltd.<br />

No An open label study. ’50% of enrolment<br />

slides, 10% of follow up slides and all slides<br />

reported as showing recrudescence were<br />

subjected to a second blind reading’<br />

43

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