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. 2017 Oct 30;2017(10):CD006491. doi: 10.1002/14651858.CD006491.pub4

Goodyer 2011.

Methods Design: prospective cohort study
Study dates: December 2004 to April 2006
Malaria transmission pattern and local antimalarial drug resistance: various destinations, not specified
Adverse event monitoring: "a post travel questionnaire… approximately 1 week after they were due to complete their course of medication"
Participants Number enrolled: 252 recruited, 185 completed pre‐ and post‐travel questionnaires
Inclusion criteria: "...to be eligible, travelers had to be at least 18 years of age and to have been prescribed or supplied... an antimalarial medication as a result of planned travel for a duration of 28 days or less."
Exclusion criteria: "travelers participating in other prospective clinical research or observational studies, pregnant travelers or travelers planning to get pregnant during the study were excluded"
Factors influencing drug allocation: "Treatment choice was solely at the discretion of the traveler and practitioner"
Country of recruitment: UK
Country of malaria exposure: various, not reported
Duration of exposure to malaria: various, median 14 days (interquartile range 9 to 20)
Type of participants: travellers
Interventions 1. Mefloquine*
2. Atovaquone‐proguanil*
3. Doxycycline*
*dosing regimen not specified
Outcomes Included in the review:
1. Any adverse effects
2. Measures of adherence to the drug regimen
Outcomes assessed not included in the review:
3. Relative importance of factors in choice of antimalarial drugs, for both healthcare professionals and travellers
Notes Funding sources: "The study was commissioned and paid for by GlaxoSmithKline"
Risk of bias
Bias Authors' judgement Support for judgement
Other bias Unclear risk 1. Confounding: moderate
"There were statistically significant differences in mean age"
Several other confounders were not reported across groups
2. Selection of participants into the study: moderate
No information is provided regarding people who did not wish to participate
3. Measurement of interventions: low
The antimalarial prescription was provided by a travel clinic which also performed the study
4. Departures from intended interventions: moderate
No information was captured regarding switches between interventions of interest
5. Missing data: serious
185/252 participants completed the pre‐ and post‐travel questionnaire. Interim loss to follow up 27%
6. Measurement of outcomes: serious
Comment: the outcome measure was subjective; participants and personnel were not blinded
7. Selection of the reported results: moderate
The number of reported side effects was reported, but not the types or severity
8. Other: serious
Funded by GlaxoSmithKline; the role of the study sponsor was not made clear