Page 162 - 80 guidelines for the treatment of malaria_opt

nd
Guidelines for the treatment of malaria – 2 edition edition
Guidelines for the treatment of malaria – 2 nd
importance CRITICAL IMPORTANT IMPORTANT IMPORTANT IMPORTANT

Quality HIGH VERY LOW VERY LOW
LOW LOW
53 fewer per 1000 (from 30 fewer 4 more per 1000 (from 2 fewer to 20 more) 9 more per 1000 (from 7 fewer to 41 more)

Absolute to 68 fewer) Not pooled Not pooled

Is DHA+PPQ an alternative to AL6 for treating uncomplicated P. falciparum malaria worldwide?
effect Relative risk (95% CI) RR 0.42 (0.26–0.67) Not pooled Not pooled RR 1.61 (0.59–4.41) RR 1.38 (0.68–2.78)

summary of findings no. of patients AL DHA + PPQ 48/524 24/662 (9.2%) (3.6%) 235/711 143/781 (33.1%) (18.3%) 42/523 25/555 (8%) (4.5%) 6/972 10/992 (0.6%) (1%) 13/572 18/575 (2.3%) (3.1%)

considerations

Other None None None None None

Imprecision No serious imprecision 7 Serious 9 Very serious 13 Very serious 14 Very serious 14

Indirectness No serious indirectness 6 No serious indirectness 6 No serious indirectness 12 No serious indirectness 6 No serious indirectness

Inconsistency No serious inconsistency 5 Serious 8 Very serious 11 No serious inconsistency 5 No serious inconsistency 5

Limitations No serious limitations 3,4 EFFICACy: total failure (P . falciparum) day 42 PCR unadjusted 1 No serious limitations 3 TRANSMISSION POTENTIAL: gametocyte development (in those negative at baseline) No serious limitations 10 No serious limitations 3 Serious 15

GRADE Table A7.3.2 Quality assessment Design EFFICACy: total failure (P . falciparum) day 42 PCR adjusted 1 Randomized trial 2 Randomized trial 2 Randomized trial HARMS: serious adverse events (including deaths) Randomized trial HARMS: early vomiting Randomized trial

148 No. of studies 4 4 3 4 2