|
Treatment effect on four transmission outcomes: |
||||||
| Patient-level outcomes (gametocytaemia) |
||||||
|
|
||||||
| Variable |
N patients |
Univariate AUC Ratio of arithmetic means (95% CI) |
P value |
N patients |
Univariate OR slide- positive gametocytaemia on day of feeding (95% CI) |
P value |
|
|
||||||
| Antimalarial |
||||||
| CQ (non-artemisinin) |
240 |
1 |
<0.00 |
337 |
1 |
<0.00 |
| SP (non-artemisinin) |
325 |
1.56 (1.27–1.93) |
1 |
520 |
3.11 (2.19–4.40) |
1 |
| CQ-SP (non-artemisinin) |
198 |
1.03 (0.81–1.32) |
227 |
1.33 (0.86–2.06) |
||
| CQ-AS (ACT) |
291 |
0.72 (0.57–0.91) |
344 |
0.42 (0.28–0.62) |
||
| SP-AS3 (ACT) |
187 |
0.62 (0.47–0.83) |
581 |
0.50 (0.32–0.78) |
||
| AL (Coartem) (ACT) |
407 |
0.18 (0.13–0.25) |
404 |
0.15 (0.08–0.29) |
||
|
|
||||||
| ACT |
||||||
| non-artemisinin |
872 |
1 |
<0.00 |
1201 |
1 |
<0.00 |
| ACT |
885 |
0.35 (0.31–0.41) |
1 |
1329 |
0.20 (0.16–0.26) |
1 |
|
|
||||||
| ACT by pre-treatment gametocytaemia |
||||||
| day 0 slide-negative |
† |
† |
||||
| non-artemisinin |
727 |
1 |
<0.00 |
994 |
1 |
<0.00 |
| ACT |
745 |
0.23 (0.19–0.28) |
1 |
1125 |
0.13 (0.10–0.17) |
1 |
| day 0 slide-positive |
||||||
| non-artemisinin |
145 |
1 |
0.054 |
164 |
1 |
|
| ACT |
140 |
0.80 (0.64–1.00) |
183 |
0.41 (0.25–0.67) |
<0.00 |
|
|
|
||||||
| ACT by parasitological treatment failure |
||||||
| No failure |
† |
|||||
| non-artemisinin |
459 |
1 |
<0.00 |
468 |
1 |
<0.00 |
| ACT |
605 |
0.31 (0.25–0.37) |
615 |
0.28 (0.20–0.38) |
1 |
|
| Failure |
1 |
|||||
| non-artemisinin |
269 |
1 |
<0.00 |
303 |
<0.00 |
|
| ACT |
218 |
0.51 (0.40–0.65) |
1 |
233 |
0.33 (0.22–0.49) |
1 |
|
|
||||||
| Mosquito-level outcomes |
||||||
|
|
||||||
| Variable |
N mosquito es |
Adjusted OR mosquito infection (95% CI)* |
P value |
N mosquito es |
Adjusted OR oocyst count per midgut in highest 50% of positive counts (4) (95% CI)* |
P value |
|
|
||||||
| Antimalarial |
||||||
| CQ (non-artemisinin) |
2194 |
1 |
0.002 |
2194 |
1 |
<0.00 |
| SP (non-artemisinin) |
6762 |
0.42 (0.20–0.87) |
4079 |
0.25 (0.09–0.75) |
1 |
|
| CQ-SP (non-artemisinin) |
1277 |
1.28 (0.43–3.85) |
1146 |
0.12 (0.03–0.58) |
||
| CQ-AS (ACT) |
974 |
0.28 (0.11–0.71) |
974 |
0.25 (0.05–1.21) |
||
| SP-AS3 (ACT) |
2793 |
0.29 (0.12–0.69) |
1439 |
0.39 (0.09–1.8) |
||
| AL (Coartem) (ACT) |
2299 |
0.22 (0.08–0.61) |
292 |
- ‡ |
||
|
|
||||||
| ACT |
||||||
| non-artemisinin |
11653 |
1 |
0.029 |
7419 |
1 |
0.165 |
| ACT |
6066 |
0.49 (0.33–0.73) |
2705 |
0.45 (0.14–1.39) |
||
|
|
||||||
| ACT by pre-treatment gametocytaemia |
||||||
| day 0 slide-negative |
||||||
| non-artemisinin |
8811 |
1 |
0.002 |
5700 |
1 |
0.008 |
| ACT |
4039 |
0.49 (0.31–0.77) |
1419 |
0.11 (0.02–0.56) |
||
| day 0 slide-positive |
||||||
| non-artemisinin |
2277 |
1 |
<0.00 |
1326 |
1 |
0.102 |
| ACT |
1870 |
0.30 (0.16–0.55) |
1 |
1129 |
0.28 (0.06–1.29) |
|
|
|
||||||
| ACT by parasitological treatment failure |
||||||
| No failure |
||||||
| non-artemisinin |
4773 |
1 |
0.003 |
2037 |
1 |
0.486 |
| ACT |
3496 |
0.46 (0.28–0.76) |
740 |
0.49 (0.07–3.62) |
||
| Failure |
||||||
| non-artemisinin |
3027 |
1 |
0.021 |
1574 |
1 |
0.294 |
| ACT |
897 |
0.37 (0.16–0.86) |
572 |
0.33 (0.04–2.59) |
||
|
at the patient level, the area under the curve of gametocyte density (microscopy measurement) during follow up (28 days), the presence of slide-positive gametocytaemia on the day of feeding; at the mosquito level, the presence of infection in mosquitoes, and high density infection in mosquitoes. * adjusted for type of serum (autologous/control) used in transmission experiment † P interaction with ACT/non-artemisinin <0.05 ‡ Mosquitoes were infected only in study 6 where oocyst data was not collected, except one mosquito in study 5 which had a missing oocyst count. | ||||||
Okell et al. Malaria Journal 2008 7:125 doi:10.1186/1475-2875-7-125 |
||||||