Evidence map›Paper›PMID 25425081›Full record

ArticleNature communications2014

Contrasting benefits of different artemisinin combination therapies as first-line malaria treatments using model-based cost-effectiveness analysis.

Lucy C Okell, Matthew Cairns, Jamie T Griffin, Neil M Ferguson, Joel Tarning, George Jagoe, Pierre Hugo, Mark Baker, Umberto D'Alessandro, Teun Bousema and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 7 pooled it
–field-weighted citation impact
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

59 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  13. Molecular Markers for Sensitive Detection ofThe American journal of tropical medicine and hygiene · 2017
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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

12 authors.

Lucy C OkellMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London W2 1PG, UK.
Matthew CairnsMRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Jamie T GriffinMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London W2 1PG, UK.
Neil M FergusonMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London W2 1PG, UK.
Joel Tarning1] Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LJ, UK [2] Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Nakhon Pathom 73170, Bangkok, Thailand.
George JagoeMedicines for Malaria Venture, 1215 Geneva 15, Switzerland.
Pierre HugoMedicines for Malaria Venture, 1215 Geneva 15, Switzerland.
Mark BakerMedicines for Malaria Venture, 1215 Geneva 15, Switzerland.
Umberto D'Alessandro1] Prince Leopold Institute of Tropical Medicine, Department of Public Health, 2000 Antwerp, Belgium [2] Medical Research Council Unit, PO Box 273 Banjul Fajara, The Gambia [3] Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Teun BousemaDepartment of Medical Microbiology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.
David UbbenMedicines for Malaria Venture, 1215 Geneva 15, Switzerland.
Azra C GhaniMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London W2 1PG, UK.

Funding

Medical Research Council G1002284Medical Research Council G1002387Medical Research Council MR/J012394/1Medical Research Council MR/K010174/1Medical Research Council MR/K012126/1Wellcome Trust
6 · The paper itself

Abstract

There are currently several recommended drug regimens for uncomplicated falciparum malaria in Africa. Each has different properties that determine its impact on disease burden. Two major antimalarial policy options are artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PQP). Clinical trial data show that DHA-PQP provides longer protection against reinfection, while AL is better at reducing patient infectiousness. Here we incorporate pharmacokinetic-pharmacodynamic factors, transmission-reducing effects and cost into a mathematical model and simulate malaria transmission and treatment in Africa, using geographically explicit data on transmission intensity and seasonality, population density, treatment access and outpatient costs. DHA-PQP has a modestly higher estimated impact than AL in 64% of the population at risk. Given current higher cost estimates for DHA-PQP, there is a slightly greater cost per case averted, except in areas with high, seasonally varying transmission where the impact is particularly large. We find that a locally optimized treatment policy can be highly cost effective for reducing clinical malaria burden.

Indexed as

AfricaAntimalarialsArtemisininsCost-Benefit AnalysisEthanolaminesFluorenesHumansLumefantrineMalaria, FalciparumModels, TheoreticalPiperazinesQuinolinesSeasonsAntimalarialsartemisininArtemisininsartenimolEthanolaminesFluorenesLumefantrinepiperaquinePiperazinesQuinolines

Identifiers

PMID25425081
PMCPMC4263185

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.