Evidence map›Paper›PMID 26599634›Full record

Trial reportPloS one2015

Risks of Hemolysis in Glucose-6-Phosphate Dehydrogenase Deficient Infants Exposed to Chlorproguanil-Dapsone, Mefloquine and Sulfadoxine-Pyrimethamine as Part of Intermittent Presumptive Treatment of Malaria in Infants.

Eugenie Poirot, Eric Vittinghoff, Deus Ishengoma, Michael Alifrangis, Ilona Carneiro, Ramadhan Hashim, Vito Baraka, Jacklin Mosha, Samwel Gesase, Daniel Chandramohan and 1 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 93% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Review
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 5 countries.

Eugenie PoirotGlobal Health Group, University of California San Francisco, San Francisco, California, United States of America.
Eric VittinghoffGlobal Health Group, University of California San Francisco, San Francisco, California, United States of America.
Deus IshengomaTanga Medical Research Centre, National Institute for Medical Research, Tanga, United Republic of Tanzania.
Michael AlifrangisCentre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
Ilona CarneiroDepartment of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Ramadhan HashimMwanza Interventions Trial Unit, National Institute for Medical Research, Mwanza, United Republic of Tanzania.
Vito BarakaTanga Medical Research Centre, National Institute for Medical Research, Tanga, United Republic of Tanzania.
Jacklin MoshaMwanza Interventions Trial Unit, National Institute for Medical Research, Mwanza, United Republic of Tanzania.
Samwel GesaseTanga Medical Research Centre, National Institute for Medical Research, Tanga, United Republic of Tanzania.
Daniel ChandramohanDepartment of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Roland GoslingGlobal Health Group, University of California San Francisco, San Francisco, California, United States of America.
Global Brain Health Institute · USNational Institute for Medical Research · TZLondon School of Hygiene & Tropical Medicine · GBMwanza Intervention Trials Unit · TZRigshospitalet · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChlorproguanil-dapsone (CD) has been linked to hemolysis in symptomatic glucose-6-phosphate dehydrogenase deficient (G6PDd) children. Few studies have explored the effects of G6PD status on hemolysis in children treated with Intermittent Preventive Treatment in infants (IPTi) antimalarial regimens. We sought to examine the joint effects of G6PD status and IPTi antimalarial treatment on incidence of hemolysis in asymptomatic children treated with CD, sulfadoxine-pyrimethamine (SP), and mefloquine (MQ).

methodsA secondary analysis of data from a double-blind, placebo-controlled trial of IPTi was conducted. Hemoglobin (Hb) measurements were made at IPTi doses, regular follow-up and emergency visits. G6PD genotype was determined at 9 months looking for SNPs for the A- genotype at coding position 202. Multivariable linear and logistic regression models were used to examine hemolysis among children with valid G6PD genotyping results. Hemolysis was defined as the absolute change in Hb or as any post-dose Hb <8 g/dL. These outcomes were assessed using either a single follow-up Hb on day 7 after an IPTi dose or Hb obtained 1 to 14 or 28 days after each IPTi dose.

findingsRelative to placebo, CD reduced Hb by approximately 0.5 g/dL at day 7 and within 14 days of an IPTi dose, and by 0.2 g/dL within 28 days. Adjusted declines in the CD group were larger than in the MQ and SP groups. At day 7, homo-/hemizygous genotype was associated with higher odds of Hb <8 g/dL (adjusted odds ratio = 6.7, 95% CI 1.7 to 27.0) and greater absolute reductions in Hb (-0.6 g/dL, 95% CI -1.1 to 0.003). There was no evidence to suggest increased reductions in Hb among homo-/hemizygous children treated with CD compared to placebo, SP or MQ.

conclusionsWhile treatment with CD demonstrated greater reductions in Hb at 7 and 14 days after an IPTi dose compared to both SP and MQ, there was no evidence that G6PD deficiency exacerbated the adverse effects of CD, despite evidence for higher hemolysis risk among G6PDd infants.

Indexed as

AntimalarialsCohort StudiesDapsoneDouble-Blind MethodDrug CombinationsFemaleGenotypeGlucosephosphate DehydrogenaseGlucosephosphate Dehydrogenase DeficiencyHemoglobinsHemolysisHumansInfantLogistic ModelsMalariaMaleAntimalarialschloroguanil, dapsone drug combinationDapsoneDrug Combinationsfanasil, pyrimethamine drug combinationGlucosephosphate DehydrogenaseHemoglobinsMefloquineProguanilPyrimethamineSulfadoxine

Identifiers

PMID26599634
PMCPMC4658078
OpenAlexW2179912193

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.