Table 1.
Clinical trials included in the analysis and fitted parameters for each trial. The study sites are shown in order of increasing transmission intensity, as estimated by the hidden semi-Markov model analysis. Prior EIRs are estimated from the Malaria Atlas Project slide prevalence for each location in the year of the trial [28, 29]
| Site and reference | Country, year | PCR correction: molecular markers | N (AL/AS-AQ) | AS-AQ manufacturer (formulation), target AQ dose* | Days of prophylaxis: posterior median (95% CI) | EIR | FOI† | Prevalence of pfmdr1 86Y, % (references) | Prevalence of pfcrt 76T, % (references) | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| AL | AS-AQ | Prior mean | Posterior median (95% CI) | ||||||||
| Fougamou [23] | Gabon, 2007–2008 | msp1,msp2,glurp | 68/68 | Sanofi-Aventis (FDC Coarsucam) 30 mg/kg | 11.6 (6.0–16.8) | 13.1 (7.6–18.6) | 0.6 | 2.3 (1.1–4.2) | 0.5 | 79.5 [30] | 97.9 [31] |
| Ndola [23] | Zambia, 2007–2009 | msp1,msp2,glurp | 69/64 | Sanofi-Aventis (FDC Coarsucam) 30 mg/kg | 10.8 (6.0–14.8) | 16.1 (9.7–25.0) | 1.2 | 4.8 (2.4–8.4) | 1.0 | No matching survey | 20.8 [32] |
| Pweto [33] | Democratic Republic of Congo 2008-2009 | msp1,msp2,glurp | 126/129 | Sanofi-Aventis (AS-AQ Winthrop FDC) 30 mg/kg | 11.3 (7.8–14.4) | 17.9 (12.1–25.6) | 50.0 | 9.3 (6.2–13.7) | 2.0 | No matching survey | No matching survey |
| Pamol [23] | Nigeria, 2007–2008 | msp1,msp2,glurp | 164/159 | Sanofi-Aventis (FDC Coarsucam) 30 mg/kg | 17.9 (12.3–22.5) | 15.4 (10.3–21.7) | 22.6 | 9.5 (4.7–21.6) | 2.2 | 61.8 [34–36] | 90.1 [37] |
| Bobo Dioulasso (unpublished‡) | Burkina Faso, 2010–2012 | msp1,msp2 | 373/372 | Sanofi-Aventis (FDC Coarsucam) 30 mg/kg | 12.5 (10.6–14.4) | 16.9 (14.0–19.9) | 21.5 | 17.4 (13.3–23.1) | 5.9 | 18.0 [38, 39] | 28.5 [38–42] |
| Gourcy (unpublished‡) | Burkina Faso, 2010–2012 | msp1,msp2 | 112/129 | Sanofi-Aventis (FDC Coarsucam) 30 mg/kg | 8.7 (6.2–10.9) | 17.8 (13.7–22.1) | 22.9 | 23.3 (15.9–33.7) | 6.5 | 18.0 [38, 39] | 24.8 [39, 41] |
| Kisumu (unpublished‡) | Kenya, 2005 | msp1,msp2 | 179/178 | Sanofi and Hoechst Marion Roussel (Loose NFDC) 30 mg/kg | 18.6 (15.8–21.2) | 14.2 (10.9–17.6) | 6.9 | 26.5 (18.1–39.6) | 5.7 | 66.6 [43–46] | 90.3 [44, 46, 47] |
| Nimba [48] | Liberia, 2008–2009 | msp1,msp2,glurp | 127/141 | Sanofi-Aventis (AS-AQ Winthrop FDC) 30 mg/kg | 17.9 (15.1–20.6) | 11.6 (8.8–14.3) | 18.3 | 32.4 (26.1–40.0) | 8.0 | 69.4 [49] | 93.5 [49] |
| Sikasso [50] | Mali 2005-2007 | msp1,msp2,CA1 | 236/233 | Sanofi-Aventis (Coblistered NFDC. Arsucam) 30 mg/kg | 10.2 (9.0–11.6) | 18.7 (16.1–21.5) | 25.2 | 37.2 (29.5–46.9) | 11.3 | 35.5 [51] | 70.2 [32, 51–54] |
| Tororo [55] | Uganda, 2009–2010 | msp1,msp2,glurp | 190/190 | Sanofi (AS-AQ Winthrop FDC) 30 mg/kg | 13.3 (11.8–14.6) | 13.4 (11.7–15.1) | 23.3 | 84.2 (72.9–96.9) | 16.9 | 63.9 [56–58] | 99.6 [56, 58] |
| Nanoro [23] | Burkina Faso, 2007–2008 | msp1,msp2,glurp | 257/273 | Sanofi-Aventis (FDC Coarsucam) 30 mg/kg | 10.1 (9.2–11.1) | 17.0 (15.0–19.2) | 52.2 | 91.9 (76.2–111.1) | 18.9 | 31.6 [38, 59] | 67.0 [32, 38, 42, 59] |
| Tororo [60] | Uganda, 2005 | msp1,msp2 | 189/195 | AQ: Parke-David, Pfizer, AS: Sanofi-Aventis (Loose NFDC) 25 mg/kg | 12.4 (11.1–13.8) | 10.2 (8.9–11.6) | 64.6 | 117.1 (98.4–139.8) | 23.3 | 79.4 [56, 61] | 96.2 [62, 63] |
*FDC fixed-dose combination, NFDC non-fixed-dose combination. AS-AQ FDC was from Sanofi. For AL, all trials used the Novartis fixed-dose combination and the same dose regimen
†FOI force of infection, estimated mean incidence of patent blood-stage infection in this trial population, given the age distribution and fitted EIR
‡ Unpublished study references: Bobo Dioulasso, Gourcy: Nikiema F, Zongo I, Some F, Ouedraogo J. Evolution of therapeutic efficacies of artemisinin-based combination therapies (ASAQ and AL) for treatment of uncomplicated falciparum malaria in Burkina Faso during five years of adoption as first-line treatments, unpublished. and Kisumu: Juma EA. Efficacy of co-administered amodiaquine plus artesunate and artemether/lumefantrine for the treatment of uncomplicated falciparum malaria in children less than five years in different epidemiological settings in Kenya, unpublished.