The effect of chloroquine dose and primaquine on Plasmodium vivax recurrence: a WorldWide Antimalarial Resistance Network systematic review and individual.

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Presentation transcript:

The effect of chloroquine dose and primaquine on Plasmodium vivax recurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient pooled meta-analysis Robert J Commons, FRACP, Prof Julie A Simpson, PhD, Kamala Thriemer, PhD, Georgina S Humphreys, PhD, Tesfay Abreha, MPH, Sisay G Alemu, MSc, Arletta Añez, PhD, Prof Nicholas M Anstey, PhD, Ghulam R Awab, PhD, Prof J Kevin Baird, PhD, Bridget E Barber, PhD, Isabelle Borghini-Fuhrer, PhD, Cindy S Chu, MD, Umberto D'Alessandro, PhD, Prabin Dahal, MSc, André Daher, MD, Peter J de Vries, PhD, Annette Erhart, MD, Margarete S M Gomes, PhD, Lilia Gonzalez-Ceron, PhD, Matthew J Grigg, PhD, Aliehsan Heidari, PhD, Jimee Hwang, MD, Prof Piet A Kager, MD, Tsige Ketema, PhD, Wasif A Khan, MHS, Prof Marcus V G Lacerda, PhD, Toby Leslie, PhD, Benedikt Ley, PhD, Kartini Lidia, MSc, Prof Wuelton M Monteiro, PhD, Prof Francois Nosten, PhD, Prof Dhelio B Pereira, MD, Giao T Phan, PhD, Aung P Phyo, PhD, Prof Mark Rowland, PhD, Prof Kavitha Saravu, MD, Prof Carol H Sibley, PhD, André M Siqueira, PhD, Kasia Stepniewska, PhD, Prof Inge Sutanto, PhD, Walter R J Taylor, MD, Prof Guy Thwaites, FRCP, Binh Q Tran, MD, Prof Hien T Tran, MD, Neena Valecha, MD, José Luiz F Vieira, PhD, Sonam Wangchuk, PhD, Timothy William, MRCP, Charles J Woodrow, PhD, Lina Zuluaga-Idarraga, PhD, Prof Philippe J Guerin, MD, Prof Nicholas J White, FRS, Prof Ric N Price, FRCP The Lancet Infectious Diseases Volume 18, Issue 9, Pages 1025-1034 (September 2018) DOI: 10.1016/S1473-3099(18)30348-7 Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Study profile *Additional patient data available from published studies that were not described in the published enrolment cohorts. The Lancet Infectious Diseases 2018 18, 1025-1034DOI: (10.1016/S1473-3099(18)30348-7) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Risk of recurrence in patients younger than 5 years receiving chloroquine alone with (A) varied chloroquine doses, and in (B) long periodicity and (C) short periodicity regions Dashed lines are the 95% CIs. Adjusted for age, sex, and baseline parasitaemia. Assumes zero effect from study site. p values are derived from a Cox model. The Lancet Infectious Diseases 2018 18, 1025-1034DOI: (10.1016/S1473-3099(18)30348-7) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Risk of recurrence according to day of parasite clearance in patients receiving chloroquine alone in (A) long and (B) short periodicity regions Dashed lines are the 95% CIs. Adjusted for age, sex, baseline parasitaemia, and chloroquine dose. Assumes zero effect from study site. p values are derived from a Cox model. The Lancet Infectious Diseases 2018 18, 1025-1034DOI: (10.1016/S1473-3099(18)30348-7) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 4 Risk of recurrence in patients receiving chloroquine alone or chloroquine plus early primaquine in (A) long and (B) short periodicity regions Dashed lines are the 95% CIs. Adjusted for age, sex, and baseline parasitaemia. Assumes zero effect from study site. p values are derived from a Cox model. The Lancet Infectious Diseases 2018 18, 1025-1034DOI: (10.1016/S1473-3099(18)30348-7) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions