Evidence map›Paper›PMID 16871329›Full record

ArticlePLoS clinical trials2006

Artemisinin combination therapies for treatment of uncomplicated malaria in Uganda.

Hasifa Bukirwa, Adoke Yeka, Moses R Kamya, Ambrose Talisuna, Kristin Banek, Nathan Bakyaita, John Bosco Rwakimari, Philip J Rosenthal, Fred Wabwire-Mangen, Grant Dorsey and 1 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLoS clinical trials, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00374205 (A Comparative Assessment of the Effectiveness of Artemether Plus Lumefantrine Versus Artesunate Plus Amodiaquine for the Treatment of Children With Uncomplicated Plasmodium Falciparum Malaria), which is not on this map. Cited by 83 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 10 pooled it
10.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00374205 phase4terminatednot on this map

A Comparative Assessment of the Effectiveness of Artemether Plus Lumefantrine Versus Artesunate Plus Amodiaquine for the Treatment of Children With Uncomplicated Plasmodium Falciparum Malaria

TypeinterventionalSponsorBernhard Nocht Institute for Tropical MedicineRan2006 to 2007Enrolled245ConditionsMalaria, FalciparumArmsArtesunate plus Amodiaquine, Artemether-Lumefantrine
3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 10 syntheses or guidelines pooled it, 118 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Artemisinin-based combination therapy for treating uncomplicated malaria.The Cochrane database of systematic reviews · 2009
    Pooled it
  10. Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Hasifa BukirwaUganda Malaria Surveillance Project, Kampala, Uganda.
Adoke Yeka
Moses R Kamya
Ambrose Talisuna
Kristin Banek
Nathan Bakyaita
John Bosco Rwakimari
Philip J Rosenthal
Fred Wabwire-Mangen
Grant Dorsey
Sarah G Staedke
Malaria Consortium · UGMinistry of Health · UGMakerere University · UGUniversity of California, San Francisco · USSan Francisco General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the efficacy and safety of artemisinin combination therapies for the treatment of uncomplicated falciparum malaria in Uganda.

designRandomized single-blind controlled trial.

settingTororo, Uganda, an area of high-level malaria transmission.

participantsChildren aged one to ten years with confirmed uncomplicated P. falciparum malaria.

interventionsAmodiaquine + artesunate or artemether-lumefantrine. OUTCOME MEASURES: Risks of recurrent symptomatic malaria and recurrent parasitemia at 28 days, unadjusted and adjusted by genotyping to distinguish recrudescences and new infections.

resultsOf 408 participants enrolled, 403 with unadjusted efficacy outcomes were included in the per-protocol analysis. Both treatment regimens were highly efficacious; no recrudescences occurred in patients treated with amodiaquine + artesunate, and only two occurred in those treated with artemether-lumefantrine. However, recurrent malaria due to new infections was common. The unadjusted risk of recurrent symptomatic malaria was significantly lower for participants treated with artemether-lumefantrine than for those treated with amodiaquine + artesunate (27% versus 42%, risk difference 15%, 95% CI 5.9%-24.2%). Similar results were seen for the risk of recurrent parasitemia (51% artemether-lumefantrine versus 66% amodiaquine + artesunate, risk difference 16%, 95% CI 6.2%-25.2%). Amodiaquine + artesunate and artemether-lumefantrine were both well-tolerated. Serious adverse events were uncommon with both regimens.

conclusionsAmodiaquine + artesunate and artemether-lumefantrine were both highly efficacious for treatment of uncomplicated malaria. However, in this holoendemic area, despite the excellent performance of both regimens in terms of efficacy, many patients experienced recurrent parasitemia due to new infections. Artemether-lumefantrine was superior to amodiaquine + artesunate for prevention of new infections. To maximize the benefit of artemisinin combination therapy in Africa, treatment should be integrated with strategies to prevent malaria transmission. The impact of frequent repeated therapy on the efficacy, safety, and cost-effectiveness of new artemisinin regimens should be further investigated.

Identifiers

PMID16871329
PMCPMC1488893
OpenAlexW2125109931

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.