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

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Analysis 15.2. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 2 Total Failure Day 63 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 203 Analysis 15.3. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 3 Total Failure Day 42 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . 204 Analysis 15.4. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 4 Total Failure Day 42 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 205 Analysis 15.5. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 5 Total Failure Day 28 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . 206 Analysis 15.6. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 6 Total Failure Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 207 Analysis 16.1. Comparison 16 Artesunate Mefloquine dose analysis: FDC versus split dose regimen, Outcome 1 Total Failure Day 63 PCR unadjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . 208 Analysis 16.2. Comparison 16 Artesunate Mefloquine dose analysis: FDC versus split dose regimen, Outcome 2 Total Failure Day 63 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208 Analysis 17.1. Comparison 17 Artesunate plus mefloquine dose analysis (versus Dihydroartemisinin-piperaquine), Outcome 1 Total Failure Day 63 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 209 Analysis 17.2. Comparison 17 Artesunate plus mefloquine dose analysis (versus Dihydroartemisinin-piperaquine), Outcome 2 Total Failure Day 28 PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . 209 Analysis 18.1. Comparison 18 How does Dihydroartemisinin-piperaquine perform?, Outcome 1 Effectiveness: Total Failure (P. falciparum) PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . 210 Analysis 19.1. Comparison 19 How does Artesunate plus mefloquine perform?, Outcome 1 Effectiveness: Total Failure (P. falciparum) PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Analysis 20.1. Comparison 20 How does Artemether-lumefantrine perform?, Outcome 1 Effectiveness: Total Failure (P. falciparum) Day PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Analysis 21.1. Comparison 21 How does Artesunate plus amodiaquine perform?, Outcome 1 Effectiveness: Total Failure (P. falciparum) PCR adjusted. . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 WHAT’S NEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263 HISTORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263 CONTRIBUTIONS OF AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263 DECLARATIONS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . . . . . . . . . . . . . . . . . . . . . 264 INDEX TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264 Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. v
[Intervention Review] Artemisinin-based combination therapy for treating uncomplicated malaria David Sinclair 1 , Babalwa Zani 2 , Sarah Donegan 1 , Piero Olliaro 3 , Paul Garner 1 1 International Health Group, Liverpool School of Tropical Medicine, Liverpool, UK. 2 South African Cochrane Centre, Medical Research Council, Cape Town, South Africa. 3 Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland Contact address: David Sinclair, International Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. davesinkers@yahoo.com. Editorial group: Cochrane Infectious Diseases Group. Publication status and date: Edited (no change to conclusions), published in Issue 4, 2009. Review content assessed as up-to-date: 25 March 2009. Citation: Sinclair D, Zani B, Donegan S, Olliaro P, Garner P. Artemisinin-based combination therapy for treating uncomplicated malaria. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD007483. DOI: 10.1002/14651858.CD007483.pub2. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background A B S T R A C T The World Health Organization recommends uncomplicated P. falciparum malaria is treated using Artemisinin-based Combination Therapy (ACT). This review aims to assist the decision making of malaria control programmes by providing an overview of the relative benefits and harms of the available options. Objectives To compare the effects of ACTs with other available ACT and non-ACT combinations for treating uncomplicated P. falciparum malaria. Search strategy We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CEN- TRAL); MEDLINE; EMBASE; LILACS, and the metaRegister of Controlled Trials (mRCT) to March 2009. Selection criteria Randomized head to head trials of ACTs in uncomplicated P. falciparum malaria. This review is limited to: dihydroartemisinin-piperaquine; artesunate plus mefloquine; artemether-lumefantrine (six doses); artesunate plus amodiaquine; artesunate plus sulfadoxine-pyrimethamine and amodiaquine plus sulfadoxine-pyrimethamine. Data collection and analysis Two authors independently assessed trials for eligibility and risk of bias, and extracted data. We analysed primary outcomes in line with the WHO ’Protocol for assessing and monitoring antimalarial drug efficacy’ and compared drugs using risk ratios (RR) and 95% confidence intervals (CI). Secondary outcomes were effects on P. vivax, gametocytes, haemoglobin, and adverse events. Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 1
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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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