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|Title: ||Chlorproguanil-dapsone for treating uncomplicated malaria (Review)|
|Authors: ||Bukirwa, H.|
Uncomplicated falciparum malaria
|Issue Date: ||2010 |
|Publisher: ||JohnWiley & Sons|
|Citation: ||Bukirwa H., Garner P., Critchley J.A. (2010). Chlorproguanil-dapsone for treating uncomplicated malaria (Review). The Cochrane Library, 1|
In Africa, malaria is often resistant to chloroquine and sulfadoxine-pyrimethamine. Chlorproguanil-dapsone is a potential alternative.
To compare chlorproguanil-dapsone with other antimalarial drugs for treating uncomplicated falciparum malaria.
We searched the Cochrane Infectious Diseases Group Specialized Register (May 2004), CENTRAL (The Cochrane Library 2004, Issue 2), MEDLINE (1966 to May 2004), EMBASE (1988 to May 2004), LILACS (May 2004), Biosis Previews (1985 to May 2004), conference proceedings, and reference lists, and contacted researchers working in this field.
Randomized and quasi-randomized controlled trials comparing chlorproguanil-dapsone to other antimalarial drugs.
Data collection and analysis
Two reviewers independently applied the inclusion criteria, extracted data, and assessed methodological quality. We calculated the risk ratio (RR) for dichotomous data and mean difference for continuous data, and presented them with 95% confidence intervals (CI).
Six trials (n = 3352) met the inclusion criteria. Chlorproguanil-dapsone (with 1.2 mg chlorproguanil) as a single dose had fewer treatment failures than chloroquine (1 trial), but more treatment failures and people with parasitaemia at day 28 than sulfadoxinepyrimethamine
(3 trials). Two trials compared the three-dose chlorproguanil-dapsone (with 2 mg chlorproguanil) regimen with sulfadoxine-pyrimethamine in new attendees. There were fewer treatment failures with chlorproguanil-dapsone by day 7 (RR 0.30, 95% CI 0.19 to 0.49; n = 827, 1 trial) and day 14 (RR 0.36, 95% CI 0.24 to 0.53; n = 1709, 1 trial). Neither trial reported total failures by day 28. A further trial was carried out in participants selected because they had previously failed sulfadoxine-pyrimethamine. Adverse event reporting was inconsistent between trials, but chlorproguanil-dapsone was associated with more adverse events leading to discontinuation of treatment compared with sulfadoxine-pyrimethamine (RR 4.54, 95% CI 1.74 to 11.82; n = 829, 1 trial). It was also associated with more red blood cell disorders (RR 2.86, 95% CI 1.33 to 6.13; n = 1850, 1 trial).
There are insufficient data about the effects of the current standard chlorproguanil-dapsone regimen (three-dose, 2 mg chlorproguanil). Randomized controlled trials that follow up to day 28, record adverse events, and use an intention-to-treat analysis are required to
inform any policy decisions.
2008: We do not plan to update this review because chlorproguanil-dapsone has been withdrawn (see the ’What’s new’ statement).|
|Appears in Collections:||Research Articles (Health-Sciences)|
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