Andersson 2008.
Methods | Design: prospective cohort study Study dates: March 2004 to November 2006 Malaria transmission pattern and local antimalarial drug resistance: malaria attack rate of 44% with P falciparum in another similar study at the time Adverse event monitoring: patient self‐reported questionnaire |
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Participants | Number enrolled: 690 soldiers sent questionnaire, 609 respondents Inclusion criteria: all Swedish soldiers deployed to Liberia within the study dates Exclusion criteria: none stated. Factors influencing drug allocation: "...mefloquine was prescribed to almost all soldiers in the first two contingents and to about two‐thirds in the last three contingents. The remaining soldiers were recommended atovaquone/ proguanil. The latter group consisted mainly of those with body weight < 70 kg and those who had already experienced adverse events with mefloquine. No other drug regimes were used". Country of recruitment: Sweden Country of malaria exposure: Liberia Duration of exposure to malaria: 6 months Type of participants: military |
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Interventions | 1. Mefloquine* 2. Atovaquone‐proguanil* *dosing regimen not specified |
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Outcomes |
Included in the review: 1. Adverse events; any, nausea, vomiting, abdominal pain, diarrhoea, headache, dizziness, abnormal dreams nightmares, insomnia sleep disturbance, depression 2. Serious adverse events; serious 3. Adverse events; other (concentration difficulties, mouth ulcers, fever, muscle pain) 4. Discontinuations of study drug due to adverse effects Outcomes assessed not included in the review: 5. Clinical cases of malaria 6. Overall satisfaction with the drug 7. Whether they would take the drug again 8. Measures of adherence to the drug regimen (data provided on aggregate) |
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Notes | Funding sources: Not stated | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Other bias | Unclear risk |
1. Confounding: moderate Information on potential confounders is not provided across prophylactic groups 2. Selection of participants into the study: moderate 609/690 (88%) response rate 3. Measurement of interventions: low All participants were issued with the study drug. 4. Departures from intended interventions: low Switches were recorded and reported 5. Missing data: serious Outcomes were reported from 3 of 5 cohorts. No information was provided for 2 remaining cohorts. 6. Measurement of outcomes: serious The outcome measure was subjective, participants and personnel were not blinded. 7. Selection of the reported results: low All outcomes prespecified in the introduction were reported. 8. Other: moderate Study sponsor not mentioned, but 2 study authors worked for GlaxoSmithKline |