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Artemisinin‐based combination therapy for treating uncomplicated malaria

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References

Additional references

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Table 1. Treatment comparisons eligible for reviewa

Question

 Analysis

 Comparisons

1. How does artesunate plus amodiaquine perform?

 

 

 

 

1.1

vs amodiaquine plus sulfadoxine‐pyrimethamine

1.2

vs artesunate plus sulfadoxine‐pyrimethamine

1.3

vs artemether‐lumefantrine (6 doses)

1.4

vs dihydroartemisinin‐piperaquine

1.5

vs artesunate plus mefloquine

2. How does artemether‐lumefantrine (6 doses) perform?

 

 

 

2.1

vs amodiaquine plus sulfadoxine‐pyrimethamine

2.2

vs artesunate plus sulfadoxine‐pyrimethamine

2.3

vs artesunate plus amodiaquine 

2.4

vs dihydroartemisinin‐piperaquine

2.5

vs artesunate plus mefloquine

3. How does dihydroartemisinin‐piperaquine perform?

 

 

3.1

vs amodiaquine plus sulfadoxine‐pyrimethamine

3.2

vs artesunate plus sulfadoxine‐pyrimethamine

3.3

vs artesunate plus amodiaquine

3.4

vs artemether‐lumefantrine (6 doses)

3.5

vs artesunate plus mefloquine

4. How does artesunate plus mefloquine perform?

 

 

4.1

vs amodiaquine plus sulfadoxine‐pyrimethamine

4.2

vs artesunate plus sulfadoxine‐pyrimethamine

4.3

vs artesunate plus amodiaquine

4.4

vs artemether‐lumefantrine (6 doses)

4.5

vs dihydroartemisinin‐piperaquine

aTo contribute to informed decision‐making, the review is limited to artemisinin combination therapies (ACTs) for which co‐formulated products are currently available or shortly to be made available (trials using co‐packaged or loose preparations of these same ACTs are included).

Figures and Tables -
Table 1. Treatment comparisons eligible for reviewa
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Table 2. Detailed search strategies

Search set

CIDG SRa

CENTRAL

MEDLINEb

EMBASEb

LILACSb

1

malaria

malaria

malaria

malaria

malaria

2

arte*

arte*

arte*

arte*

arte*

3

dihydroarte*

dihydroarte*

dihydroarte*

dihydroarte*

dihydroarte*

4

amodiaq*

amodiaq*

amodiaq*

amodiaq$

amodiaq$

5

lumefantrine

lumefantrine

lumefantrine

lumefantrine

lumefantrine

6

Coartem*

Coartem*

Coartem*

Coartem$

Coartem$

7

mefloquine

mefloquine

mefloquine

mefloquine

mefloquine

8

2 or 3

2 or 3

2 or 3

2 or 3

2 or 3

9

4 or 5 or 6 or 7

4 or 5 or 6 or 7

4 or 5 or 6 or 7

4 or 5 or 6 or 7

4 or 5 or 6 or 7

10

1 and 8 and 9

1 and 8 and 9

1 and 8 and 9

1 and 8 and 9

1 and 8 and 9

11

 —

 —

Limit 10 to humans

Limit 10 to human

 —

aCochrane Infectious Diseases Group Specialized Register.
bSearch terms used in combination with the search strategy for retrieving trials developed by The Cochrane Collaboration (Levebvre 2008); upper case: MeSH or EMTREE heading; lower case: free text term.

Figures and Tables -
Table 2. Detailed search strategies
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Table 3. Primary outcome measure (total failure): primary and sensitivity analysesa

Analysis

Participants

PCRb‐adjusted

PCR‐unadjusted

Numerator

Denominator

Numerator

Denominator

Primary analysis

Exclusions after enrolment

Excludedc

Excluded

Excluded

Excluded

Missing or indeterminate PCR

Excluded

Excluded

Included as failures

Included

New infections

Excluded

Excluded

Included as failures

Included

Sensitivity analysis 1d

As 'Primary analysis' except: missing or indeterminate PCR

Included as failures

Included

—

—

Sensitivity analysis 2e

As 'Sensitivity analysis 1' except: new infections

Included as successes

Included

—

—

Sensitivity analysis 3f

As 'Sensitivity analysis 2' except: exclusions after enrolment

Included as failures

Included

Included as failures

Included

Sensitivity analysis 4g

As 'Sensitivity analysis 2' except: exclusions after enrolment

Included as successes

Included

Included as successes

Included

aNote: participants who were found to not satisfy the inclusion criteria after randomization are removed from all calculations.
bPCR: polymerase chain reaction.
c"Excluded" means removed from the calculation.
dTo re‐classify all indeterminate or missing PCR results as treatment failures in the PCR‐adjusted analysis.
eTo re‐classify all PCR‐confirmed new infections as treatment successes in the PCR‐adjusted analysis. (This analysis may overestimate efficacy as PCR is not wholly reliable and some recrudescences may be falsely classified as new infections. Also some participants may have gone on to develop a recrudescence after the new infection.)
fTo re‐classify all exclusions after enrolment (losses to follow up, withdrawn consent, other antimalarial use, or failure to complete treatment) as treatment failures. For PCR‐unadjusted total failure this represents a true worse‐case scenario.
gTo re‐classify all exclusions after enrolment (losses to follow up, withdrawn consent, other antimalarial use, or failure to complete treatment) as treatment successes.

Figures and Tables -
Table 3. Primary outcome measure (total failure): primary and sensitivity analysesa
Navigate to table in Protocol