Page 163 - 80 guidelines for the treatment of malaria_opt

ANNEX 7. Uncomplicated Plasmodium falciparum malaria

No serious indirectness: trials were conducted in Africa (Burkina Faso and Uganda) and Asia (Indonesia) in areas of high, moderate and unstable transmission; children aged <6 months and

Serious inconsistency: heterogeneity was high so data were not pooled; however, all trials favoured DHA+PPQ but the magnitude of this benefit was variable between settings.

In these trials both drugs have total failure rates (PCR adjusted) at day 42 of less than 10% in line with WHO recommendations.
Serious inconsistency: heterogeneity was high so data were not pooled; two trials showed benefit with DHA+PPQ and one trial found no difference.

Very serious imprecision: the 95% CI of the pooled estimate is wide including appreciable benefit and harm with each drug over the other.

No serious imprecision: both limits of the 95% CI of the pooled estimate imply appreciable benefit with DHA+PPQ over AS+MQ.

Please note that due to its longer half-life, treatment failure with DHA+PPQ may be underestimated at this point in time.
No serious limitations: allocation concealment was adequate in three trials; laboratory staff were blinded in two trials.
No difference has been shown in the incidence of serious adverse events (low quality evidence).
No serious limitations: allocation concealment was adequate in all trials; laboratory staff were blinded in three trials.
DHA+PPQ is more effective at treating P. falciparum than AL6 (high quality evidence).
Serious imprecision: the unpooled data suggest a significant but variable benefit with DHA+PPQ over AL6.
No serious indirectness: trials were conducted in Africa in moderate to high transmission settings.

A7

Burkina Faso (2), Indonesia (15) and Uganda (16,17). Data is also available for treatment failure at day 28, but provides no further useful information. No serious inconsistency: heterogeneity was low. pregnant or lactating women were excluded. Very serious imprecision: data not pooled. Serious limitations: staff and participants w

panel comment: panel conclusion:

10.
11.
14.
15.
12.
13.
6.
2.
5.
3.
4.
8.
9.
7.
1.

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