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Analysis 6.1. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 1 Total Failure (P. falciparum) Day 42 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . 155 Analysis 6.2. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 2 Total Failure (P. falciparum) Day 42 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Analysis 6.3. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 3 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . 156 Analysis 6.4. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 4 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Analysis 6.5. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 5 P. vivax parasitaemia. 158 Analysis 6.6. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 6 Gametocyte development (in those negative at baseline). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Analysis 6.7. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 7 Gametocyte carriage. 160 Analysis 6.8. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 8 Serious adverse events (including deaths). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Analysis 6.9. Comparison 6 Artesunate plus mefloquine vs Artemether-lumefantrine, Outcome 9 Early vomiting. . 162 Analysis 7.1. Comparison 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . 162 Analysis 7.2. Comparison 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Analysis 7.3. Comparison 7 Artesunate plus mefloquine vs Artesunate plus amodiaquine, Outcome 3 Gametocyte carriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Analysis 8.1. Comparison 8 Artesunate plus mefloquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . 164 Analysis 8.2. Comparison 8 Artesunate plus mefloquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . 165 Analysis 8.3. Comparison 8 Artesunate plus mefloquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 3 Gametocyte carriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Analysis 9.1. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . 166 Analysis 9.2. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Analysis 9.3. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 3 Gametocyte development. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Analysis 9.4. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 4 Gametocyte carriage. 168 Analysis 9.5. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 5 Anaemia. . . . 169 Analysis 9.6. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 6 Proportion anaemic (Haemoglobin < 11 g/dl). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Analysis 9.7. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 7 Serious adverse events (including deaths). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Analysis 9.8. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 8 Early vomiting. . 171 Analysis 9.9. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 9 Sensitivity analysis: Total Failure Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . 172 Analysis 9.10. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 10 Sensitivity analysis: Total Failure Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . 174 Analysis 10.1. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 42 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . 176 Analysis 10.2. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 42 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 177 Analysis 10.3. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 3 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . 178 Analysis 10.4. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 4 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 179 Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. iii
Analysis 10.5. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 5 P. vivax parasitaemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Analysis 10.6. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 6 Sensitivity analysis Total Failure Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . 181 Analysis 10.7. Comparison 10 Artemether-lumefantrine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 7 Sensitivity analysis: Total Failure Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . 182 Analysis 11.1. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . 183 Analysis 11.2. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . 184 Analysis 11.3. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 3 Total Failure (P. falciparum) Day 42 PCR unadjusted. . . . . . . . . . . . . . . . . . . . 185 Analysis 11.4. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 4 Total Failure (P. falciparum) Day 42 PCR adjusted. . . . . . . . . . . . . . . . . . . . . 185 Analysis 11.5. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 5 Gametocyte carriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Analysis 11.6. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 6 Gametocyte development (in those negative at baseline). . . . . . . . . . . . . . . . . . . . 187 Analysis 11.7. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 7 Anaemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188 Analysis 11.8. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 8 Serious adverse events (including deaths). . . . . . . . . . . . . . . . . . . . . . . . . 188 Analysis 11.9. Comparison 11 Artemether-lumefantrine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 9 Early vomiting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Analysis 12.1. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . 190 Analysis 12.2. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . 191 Analysis 12.3. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 3 Gametocyte carriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Analysis 12.4. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 4 Proportion of participants with anaemia. . . . . . . . . . . . . . . . . . . . . . . . . 193 Analysis 12.5. Comparison 12 Artesunate plus amodiaquine vs Artesunate plus sulfadoxine-pyrimethamine, Outcome 5 Serious adverse events (including deaths). . . . . . . . . . . . . . . . . . . . . . . . . 194 Analysis 13.1. Comparison 13 Artesunate plus amodiaquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 1 Total Failure (P. falciparum) Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . 195 Analysis 13.2. Comparison 13 Artesunate plus amodiaquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 2 Total Failure (P. falciparum) Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . 196 Analysis 13.3. Comparison 13 Artesunate plus amodiaquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 3 Gametocyte development. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Analysis 13.4. Comparison 13 Artesunate plus amodiaquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 4 Gametocyte carriage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Analysis 13.5. Comparison 13 Artesunate plus amodiaquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 5 Anaemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Analysis 13.6. Comparison 13 Artesunate plus amodiaquine vs Amodiaquine plus sulfadoxine-pyrimethamine, Outcome 6 Serious adverse events (including deaths). . . . . . . . . . . . . . . . . . . . . . . . . 200 Analysis 14.1. Comparison 14 Dihydroartemisinin-piperaquine dose analysis: 3 dose vs 4 dose regimen, Outcome 1 Total Failure PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200 Analysis 14.2. Comparison 14 Dihydroartemisinin-piperaquine dose analysis: 3 dose vs 4 dose regimen, Outcome 2 Total Failure PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Analysis 15.1. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 1 Total Failure Day 63 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . 202 Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. iv
Page 1 and 2: Artemisinin-based combination thera
Page 3: Analysis 2.2. Comparison 2 Dihydroa
Page 7 and 8: [Intervention Review] Artemisinin-b
Page 9 and 10: B A C K G R O U N D Malaria is a di
Page 11 and 12: drugs and the treatment comparisons
Page 13 and 14: this analysis into participants who
Page 15 and 16: Figure 1. Methodological quality su
Page 17 and 18: confidence intervals of the estimat
Page 19 and 20: Anaemia Hasugian 2005 IDN found tha
Page 21 and 22: Three trials report significantly m
Page 23 and 24: or those treated for P. vivax at ba
Page 25 and 26: Early vomiting Not reported. D I S
Page 27 and 28: Figure 4. Olliaro-Vaillant plot. Da
Page 33 and 34: Figure 10. Olliaro-Vaillant plot. D
Page 35 and 36: of findings tables’. For these ta
Page 37 and 38: Huambo and Bie provinces, central A
Page 39 and 40: References to studies excluded from
Page 41 and 42: Adjuik 2004 Adjuik M, Babiker A, Ga
Page 43 and 44: C H A R A C T E R I S T I C S O F S
Page 45 and 46: Ashley 2003a THA (Continued) Outcom
Page 47 and 48: Ashley 2003b THA (Continued) Alloca
Page 49 and 50: Ashley 2005 THA (Continued) Exclusi
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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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Analysis 1.3. Comparison 1 Dihydroa
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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 A
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Analysis 6.6. Comparison 6 Artesuna
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Analysis 9.2. Comparison 9 Artemeth
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Analysis 9.8. Comparison 9 Artemeth
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Analysis 10.2. Comparison 10 Arteme
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Analysis 12.2. Comparison 12 Artesu
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Analysis 14.2. Comparison 14 Dihydr
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Analysis 20.1. Comparison 20 How do
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Analysis 21.1. Comparison 21 How do
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(Continued) 2. How does artesunate
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(Continued) Sensitivity analysis 1
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(Continued) Smithuis 2004 MMR (652
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Dihydroartemisinin-piperaquine vs A
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(Continued) Mayxay 2003 LAO (220 pa
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Artesunate plus mefloquine vs Amodi
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(Continued) Faye 2003 SEN (509 part
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Artemether-lumefantrine vs Artesuna
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(Continued) Zongo 2005 BFA (521 par
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(Continued) Faye 2003 SEN (521 part
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PCR = polymerase chain reaction PCV
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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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