Evidence map›Paper›PMID 18545692›Full record

Trial reportPloS one2008

Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treating uncomplicated malaria: a randomized trial to guide policy in Uganda.

Adoke Yeka, Grant Dorsey, Moses R Kamya, Ambrose Talisuna, Myers Lugemwa, John Bosco Rwakimari, Sarah G Staedke, Philip J Rosenthal, Fred Wabwire-Mangen, Hasifa Bukirwa

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 10 pooled it
14.3field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 10 syntheses or guidelines pooled it, 147 citations in OpenAlex.

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  10. Artemisinin-based combination therapy for treating uncomplicated malaria.The Cochrane database of systematic reviews · 2009
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  14. Changing Antimalarial Drug Sensitivities in Uganda.Antimicrobial agents and chemotherapy · 2017
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35 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

10 authors at 5 institutions in 3 countries.

Adoke YekaUganda Malaria Surveillance Project, Kampala, Uganda.
Grant Dorsey
Moses R Kamya
Ambrose Talisuna
Myers Lugemwa
John Bosco Rwakimari
Sarah G Staedke
Philip J Rosenthal
Fred Wabwire-Mangen
Hasifa Bukirwa
Ministry of Health · UGMakerere University · UGMalaria Consortium · UGUniversity of California, San Francisco · USLondon School of Hygiene & Tropical Medicine · GB

Funding

PHS HHS U50/CCU925122-01
6 · The paper itself

Abstract

backgroundUganda recently adopted artemether-lumefantrine (AL) as the recommended first-line treatment for uncomplicated malaria. However, AL has several limitations, including a twice-daily dosing regimen, recommendation for administration with fatty food, and a high risk of reinfection soon after therapy in high transmission areas. Dihydroartemisinin-piperaquine (DP) is a new alternative artemisinin-based combination therapy that is dosed once daily and has a long post-treatment prophylactic effect. We compared the efficacy and safety of AL with DP in Kanungu, an area of moderate malaria transmission. METHODOLOGY/PRINCIPAL

findingsPatients aged 6 months to 10 years with uncomplicated falciparum malaria were randomized to therapy and followed for 42 days. Genotyping was used to distinguish recrudescence from new infection. Of 414 patients enrolled, 408 completed follow-up. Compared to patients treated with artemether-lumefantrine, patients treated with dihydroartemisinin-piperaquine had a significantly lower risk of recurrent parasitaemia (33.2% vs. 12.2%; risk difference = 20.9%, 95% CI 13.0-28.8%) but no statistically significant difference in the risk of treatment failure due to recrudescence (5.8% vs. 2.0%; risk difference = 3.8%, 95% CI -0.2-7.8%). Patients treated with dihydroartemisinin-piperaquine also had a lower risk of developing gametocytaemia after therapy (4.2% vs. 10.6%, p = 0.01). Both drugs were safe and well tolerated. CONCLUSIONS/SIGNIFICANCE: DP is highly efficacious, and operationally preferable to AL because of a less intensive dosing schedule and requirements. Dihydroartemisinin-piperaquine should be considered for a role in the antimalarial treatment policy of Uganda.

trial registrationControlled-Trials.com ISRCTN75606663.

Indexed as

Health PolicyAntimalarialsArtemetherArtemisininsChildChild, PreschoolDrug Therapy, CombinationEthanolaminesFluorenesHumansInfantLumefantrineMalaria, FalciparumPiperazinesQuinolinesUgandaAntimalarialsArtemetherArtemisininsartenimolEthanolaminesFluorenesLumefantrinepiperaquinePiperazinesQuinolines

Identifiers

PMID18545692
PMCPMC2405936
OpenAlexW2048834380

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.