Page 164 - 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 MODERATE MODERATE VERY LOW VERY LOW
–
39 fewer per 1000 (from 4 fewer 76 fewer per 1000 (from 31 fewer 15 fewer per 1000 (from 18 fewer 37 fewer per 1000 (from 61 fewer

Absolute to 56 fewer) to 105 fewer) – to 31 more) to 23 more)

Is DHA+PPQ an alternative to AS+AQ for treating uncomplicated P. falciparum malaria worldwide?

effect Relative risk (95% CI) RR 0.47 (0.23– 0.94) RR 0.53 (0.35–0.81) – RR 0.14 (0.01–2.71) RR 0.53 (0.22–1.3)

summary of findings no. of patients AS + AQ DHA + PPQ 22/303 11/326 (7.3%) (3.4%) 54/335 29/344 (16.1%) (8.4%) – – 3/166 0/168 (1.8%) (0%) 13/166 7/168 (7.8%) (4.2%)

considerations

Other None None – None None

Imprecision No serious imprecision 7 No serious imprecision 7 – Very serious 10 Very serious 10

Indirectness Serious 6 Serious 6 – Serious 9 Serious 9

Inconsistency No serious inconsistency 5 No serious inconsistency 5 Not applicable Not applicable

Limitations No serious limitations 3,4 EFFICACy: total failure (P . falciparum) day 28 PCR unadjusted 1 No serious limitations 3 TRANSMISSION POTENTIAL: gametocyte carriage – not measured 8 – No serious limitations 3 Serious 11

GRADE Table A7.3.3 Quality assessment Design EFFICACy: total failure (P . falciparum) day 28 PCR adjusted 1 Randomized trial 2 Randomized trial 2 – – HARMS: serious adverse events (including deaths) Randomized trial HARMS: early vomiting Randomized trial

150 No. of studies 2 2 2 1 1