scholarly journals REDIMEH Project:Ibero-American Integrative Network for Clinical Research in Homeopathy

2021 ◽  
Vol 8 (27) ◽  
pp. 50-52
Author(s):  
José Eizayaga
Keyword(s):  
Atopic Dermatitis ◽  
Clinical Research ◽  
Clinical Data ◽  
Daily Practice ◽  
Randomized Control Trials ◽  
High Dilution ◽  
High Quality ◽  
Palabras Clave ◽  
Randomized Control ◽  
Integrative Network

If there were one lacking or insufficient issue which conscious medical orientated homeopaths could regret, it would be probably high quality clinical research. A big part of the homeopathic community still insists in the traditional ways of building knowledge, leading us nowhere. There is now an agreement between clinical researchers that there have been done enough efforts with Randomized Control Trials (RCT). But what we need today is good quality scientific research that could improve our daily practice. This article introduce the REDIMEH, an Ibero-American Integrative Network for Clinical Research in Homeopathy, horizontal in structure, with no political objectives, with the only intention of joining efforts in order to obtain enough clinical data to draw out valid conclusions. Keywords: REDIMED, atopic dermatitis, clinical research.  Projeto REDIMED: Red Integrada Ibero-Americana para Pesquisa Clínica em Homeopatia ResumoSe pudermos apontar uma questão, a qual os verdadeiros médicos homeopatas podem se lamentar, esta deveria ser a falta ou insuficiéncia de pesquisas clínicas de alta qualidade. Uma grande parte da comunidade homeopática ainda insiste nas formas tradicionais de construção de conhecimento, levando-nos a lugar algum. Existem pontos bem estabelecidos pelos pesquisadores clínicos que tem se esforçado muito com a realização de Ensaios Controlados Randomizados (RCT). O que mais precisamos hoje é de investigação científica de boa qualidade, que possa melhorar a nossa prática diária. Este artigo apresenta o projeto REDIMEH, uma Rede Integrada Ibero-Americana para Pesquisa Clínica em Homeopatia, de estrutura horizontal, sem objetivos políticos, com a intenção de unir esforços no sentido de obter dados clínicos suficientes para chegarmos a conclusões válidas para a prática clínica diária. Palavras-chave: REDIMED, dermatite atópica, investigação clínica.  Proyecto REDIMEH: Red Iberoamericana Integrativa de Investigación Clínica en Homeopatía ResumenSi hubiera uma cuestión de la cual los médicos homeopatas podrían pesar, sería probablemente la investigación clínica de alta calidad. Una gran parte de la comunidad homeopática sigue insistiendo en las formas tradicionales de construcción del conocimiento, que nos conduce a ninguna parte. En la actualidad, existe un acuerdo entre los investigadores clínicos, que ya se han hecho lo suficiente con los esfuerzos de control de ensayos aleatorios (RCT). Pero lo que necesitamos hoy es la investigación científica de buena calidad que pueda mejorar nuestra práctica diaria. Este artículo presentará el REDIMEH, uma Red Iberoamericana Integrativa de Investigación Clínica en Homeopatía, con una estructura horizontal, sin objetivos políticos, con la única intención de unir esfuerzos con el propósito de obtener datos clínicos suficientes para sacar conclusiones válidas. Palabras-clave: REDIMED, dermatitis atópica, investigación clínica  Correspondence author: Jose Eizayaga, [email protected], www.maimonides.edu How to cite this article: Eizayaga J. REDIMEH Project: Ibero-American Integrative Network for Clinical Research in Homeopathy. Int J High Dilution Res [online]. 2009 [cited YYYY Month dd]; 8(27): 50-52. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/340/392.  

scholarly journals What role should randomized control trials play in providing the evidence base for conservation?

Oryx ◽  
2019 ◽  
pp. 1-10 ◽  
Author(s):  
Edwin L. Pynegar ◽  
James M. Gibbons ◽  
Nigel M. Asquith ◽  
Julia P. G. Jones
Keyword(s):  
Large Scale ◽  
Relevant Literature ◽  
Evidence Base ◽  
Randomized Control Trials ◽  
High Quality ◽  
Bolivian Andes ◽  
Behavioural Effects ◽  
Randomized Control ◽  
The Impact ◽  
Conservation Interventions

AbstractThe effectiveness of many widely used conservation interventions is poorly understood because of a lack of high-quality impact evaluations. Randomized control trials (RCTs), in which experimental units are randomly allocated to treatment or control groups, offer an intuitive way to calculate the impact of an intervention by establishing a reliable counterfactual scenario. As many conservation interventions depend on changing people's behaviour, conservation impact evaluation can learn a great deal from RCTs in fields such as development economics, where RCTs have become widely used but are controversial. We build on relevant literature from other fields to discuss how RCTs, despite their potential, are just one of a number of ways to evaluate impact, are not feasible in all circumstances, and how factors such as spillover between units and behavioural effects must be considered in their design. We offer guidance and a set of criteria for deciding when RCTs may be an appropriate approach for evaluating conservation interventions, and factors to consider to ensure an RCT is of high quality. We illustrate this with examples from one of the few concluded RCTs of a large-scale conservation intervention: an incentive-based conservation programme in the Bolivian Andes. We argue that conservation should aim to avoid a rerun of the polarized debate surrounding the use of RCTs in other fields. Randomized control trials will not be feasible or appropriate in many circumstances, but if used carefully they can be useful and could become a more widely used tool for the evaluation of conservation impact.

scholarly journals Scientific framework of homeopathy: evidence-based homeopathy

2021 ◽  
Vol 7 (23) ◽  
pp. 72-92
Author(s):  
Michel Van Wassenhoven
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Evidence Based ◽  
Review Of Literature ◽  
High Dilution ◽  
Randomized Controlled ◽  
Palabras Clave ◽  
Meta Analyses ◽  
Based Medicine ◽  
Scientific Framework

This paper aims at considering all important aspects of the scientific framework of homeopathic practice, looking at the levels of scientific evidence of each aspect in an objective way, through an extensive review of literature. Levels of evidence considered are: I) existence of meta-analyses and/or systematic positive reviews of literature; IIa) multiple positive randomized controlled trials (RCTs); IIb) some positive RCTs; IIIa) positive multiple cohorts studies; IIIb) positive studies with some cohorts; IV) opinion of experts (clinical and daily practice cases). Conclusions are clear: homeopathy must stay within the framework of medical practice, and it is even a necessity for public health. Keywords: Evidence-Based medicine, Homeopathy, Scientific framework, Literature review.   Marco científico da homeopatia: homeopatia baseada em evidéncias Resumo O presente artigo aborda aspectos importantes do marco científico da prática homeopática, focando os níveis de evidéncia de cada um deles de maneira objetica, através de uma revisão extensa da literatura. Os níveis de evidéncia considerados são: I) existéncia de meta-análises e/ou revisões sistemáticas positivas da literatura; IIa) múltiplos estudos randomizados controlados (RCTs) positivos; IIb) alguns RCTs positivos; IIIa) estudos de coortes múltiplas positivos; IIIb) estudos com algumas coortes positivos; IV) opinião de expertos (casos clínicos da prática cotidiana). As conclusões são claras: a homeopatia deve permanecer dentro do marco da prática médica, sendo, inclusive, uma necessidade para a saúde pública. Palavras-chave: Medicina Baseada em Evidéncias, Homeopatia, Estrutura ciéntifica, Revisão de literatura.   Marco científico de la homeopatía: homeopatía basada en evidencia Resumen Este artículo aborda aspectos importantes del marco científico de la práctica homeopática, enfocando los niveles de evidencia de cada aspecto, de modo objetivo, mediante una revisión extensiva de la literatura. Los niveles de evidencia considerados son: I) existencia de meta-análisis y/o revisiones sistemáticas positivas de la literatura; IIa) múltiples ensayos randomizados controlados (RCTs) positivos; IIb) algunos RCTs positivos; IIIa) estudios con cohortes múltiplas positivos; IIIb) estudios con algunas cohortes positivos; IV) opinión de expertos (casos clínicos de la práctica cotidiana). Las conclusiones son claras: la homeopatía debe permanecer dentro del marco de la práctica médica, siendo, inclusive, una necesidad para la salud pública. Palabras-clave: Medicina enbasada en evidencia, homeopatía, estructura científica, Revisión de la literatura.   Correspondence author: Michel van Wassenhoven, [email protected] How to cite this article: Wassenhoven MV. Scientific framework of homeopathy: Evidence-based Homeopathy. Int J High Dilution Res [online]. 2008 [cited YYYY Mmm DD]; 7(23): 72-92. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/286/354.  

scholarly journals Safety of Dihydroartemisinin-Piperaquine Versus Artemether-Lumefantrine For the Treatment of Uncomplicated Plasmodium Falciparum Malaria Among Children in Africa: a Systematic Review and Meta-Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Dawit Getachew Assefa ◽  
Gizachew Yismaw ◽  
Eyasu Makonnen
Keyword(s):  
Meta Analysis ◽  
Plasmodium Falciparum Malaria ◽  
Randomized Control Trials ◽  
High Quality ◽  
Quality Of Evidence ◽  
Online Databases ◽  
Randomized Control ◽  
Comparative Safety ◽  
Uncomplicated Plasmodium Falciparum Malaria

Abstract Background: The efficacies of artemisinin based combinations have been excellent in Africa, but little or no attention has been given to their safety. The aim of this review was to synthesize available evidence on the safety of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated P.falciparum malaria among children in Africa.Method: A systematic literature search was done to identify relevant articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Center for Clinical Trial database (CENTRAL) for retrieving randomized control trials comparing safety of DHA-PQ and AL for treatment of uncomplicated P.falciparum malaria among children in Africa. The search was performed from August 2020 to 30 April 2021. Using Rev-Man software (V5.4.1), the extracted data from eligible studies were pooled as risk ratio (RR) with 95% confidence interval (CI).Result: In this review, 18 studies were included, which involved 10,498 participants were included. Compared to AL, DHA-PQ was associated with a slightly higher frequency of early vomiting (RR 2.26, 95% CI 1.46 to 3.50; participants = 7796; studies = 10; I2 = 0%, high quality of evidence), cough (RR 1.06, 95% CI 1.01 to 1.11; participants = 8013; studies = 13; I2 = 0%, high quality of evidence), and diarrhea (RR 1.16, 95% CI 1.03 to 1.31; participants = 6841; studies = 11; I2 = 8%, high quality of evidence) were more frequent in DHA-PQ treatment arm. Conclusion: From this review, it can be concluded that early vomiting, diarrhea, and cough were significantly more frequent in patients who were treated with the DHA-PQ than that of AL, and both drugs are well tolerated. More studies comparing AL with DHA-PQ are needed to determine the comparative safety of these drugs.

scholarly journals Safety of Dihydroartemisinin-piperaquine Versus Artemether-lumefantrine for the Treatment of Uncomplicated Plasmodium Falciparum Malaria Among Children in Africa: A Systematic Review and Meta-analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Dawit Getachew Assefa ◽  
Gizachew Yesmaw ◽  
Eyasu Makonnen
Keyword(s):  
Meta Analysis ◽  
Plasmodium Falciparum Malaria ◽  
Randomized Control Trials ◽  
High Quality ◽  
Quality Of Evidence ◽  
Online Databases ◽  
Randomized Control ◽  
Comparative Safety ◽  
Uncomplicated Plasmodium Falciparum Malaria

Abstract Background: The efficacies of artemisinin based combinations have been excellent in Africa, but little or no attention has been given to their safety. The aim of this review was to synthesize available evidence on the safety of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated P.falciparum malaria among children in Africa.Method: A systematic literature search was done to identify relevant articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Center for Clinical Trial database (CENTRAL) for retrieving randomized control trials comparing safety of DHA-PQ and AL for treatment of uncomplicated P.falciparum malaria among children in Africa. The search was performed from August 2020 to 30 April 2021. Using Rev-Man software (V5.4.1), the extracted data from eligible studies were pooled as risk ratio (RR) with 95% confidence interval (CI).Result: In this review, 18 studies were included, which involved 10,498 participants were included. Compared to AL, DHA-PQ was associated with a slightly higher frequency of early vomiting (RR 2.26, 95% CI 1.46 to 3.50; participants = 7796; studies = 10; I2 = 0%, high quality of evidence), cough (RR 1.06, 95% CI 1.01 to 1.11; participants = 8013; studies = 13; I2 = 0%, high quality of evidence), and diarrhea (RR 1.16, 95% CI 1.03 to 1.31; participants = 6841; studies = 11; I2 = 8%, high quality of evidence) were more frequent in DHA-PQ treatment arm.Conclusion: From this review, it can be concluded that early vomiting, diarrhea, and cough were significantly more frequent in patients who were treated with the DHA-PQ than that of AL, and both drugs are well tolerated. More studies comparing AL with DHA-PQ are needed to determine the comparative safety of these drugs.

Efficacy and Safety of Dihydroartemisinin-Piperaquine Versus Artemether-Lumefantrine for Treatment of Uncomplicated Plasmodium Falciparum Malaria In African Children: A Systematic Review And Meta-Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Dawit Getachew Assefa ◽  
Gizachew Yesmaw ◽  
Eyasu Makonnen
Keyword(s):  
Plasmodium Falciparum ◽  
Treatment Failure ◽  
Meta Analysis ◽  
Randomized Control Trials ◽  
Efficacy And Safety ◽  
High Quality ◽  
Quality Of Evidence ◽  
African Children ◽  
Randomized Control

Abstract Background: Emergence of Plasmodium falciparum resistance to artemisinin and its derivatives poses a threat to global effort in controlling malaria. Resistance has already emerged to most antimalarial drugs in common use. On the other hand, significant number of the developing world in genral and African population in particular is sufferring from malaria of whom many are children.The aim of this review was, therefore, to compare the efficacy and safety of dihydroartemisinin-piperaquine and artemether-lumefantrine for treatment of uncomplicated P.falciparum malaria in African children.Method: A computerized systematic search method was used to search for articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Center for Clinical Trial database (CENTRAL) for retrieving randomized control trials comparing efficacy and safety of DHA-PQ and AL for treatment of uncomplicated P.falciparum malaria in African children. The search was performed from August 2020 to 30 April 2021. Using Rev-Man software (V5.4), R-studio, and Comprehensive Meta-analysis software, the extracted data from eligible studies were pooled as risk ratio (RR) with 95% confidence interval (CI).Result: In this review, 25 studies which involved a total of 13,198 participants were included. PCR unadjusted treatment failure in children aged between 6 months and 15 years was significantly lower in DHA-PQ treatment arm on day 28 than that of AL (RR 0.14, 95% CI 0.08 to 0.26; participants = 1302; studies = 4; I2 = 0%, high quality of evidence). Consistently, the PCR adjusted treatment failure was significantly lower with DHA-PQ treatment group on day 28 (RR 0.45, 95% CI 0.29 to 0.68; participants = 8508; studies = 16; I2 = 51%, high quality of evidence) and on day 42 (RR 0.60, 95% CI 0.47 to 0.78; participants = 5959; studies = 17; I2 = 0%, high quality of evidence). However, the efficacy was ≥95% in both treatment groups on day 28. On days 28 and 42, a significant increase in serum hemoglobin level from the baseline was also observed in DHA-PQ treatment arm (SMD 0.15, 95% CI 0.05 to 0.26; participants = 2715; studies = 4; I2 = 32%, high quality of evidence) and (MD 0.35, 95% CI 0.12 to 0.59; participants = 1434; studies = 3; I2 = 35%, high quality of evidence), respectively. Compared to AL, DHA-PQ was associated with a slightly higher frequency of early vomiting (RR 2.26, 95% CI 1.46 to 3.50; participants = 7796; studies = 10; I2 = 0%, high quality of evidence), vomiting (RR 1.02, 95% CI 0.87 to 1.19; participants = 8789; studies = 13; I2 = 20%, high quality of evidence), cough (RR 1.06, 95% CI 1.01 to 1.11; participants = 8013; studies = 13; I2 = 0%, high quality of evidence), and diarrhea (RR 1.16, 95% CI 1.03 to 1.31; participants = 6841; studies = 11; I2 = 8%, high quality of evidence) were more frequent in DHA-PQ treatment arm.Conclusion: From this review, it can be concluded that DHA-PQ reduces new infection and recrudescence with significant impact on hemoglobin recovery more than AL, and both drugs are well tolerated. DHA-PQ may, therefore be recommended as a first line treatment for uncomplicated P.falciparum malaria in Africa, while use of AL continues.

scholarly journals A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder

2016 ◽  
Vol 31 (7) ◽  
pp. 857-870 ◽  
Author(s):  
Nick Preston ◽  
Sara Magallón ◽  
Liam JB Hill ◽  
Elizabeth Andrews ◽  
Sara M Ahern ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Motor Skills ◽  
Systematic Reviews ◽  
Developmental Coordination Disorder ◽  
Motor Training ◽  
Evidence Based ◽  
Randomized Control Trials ◽  
High Quality ◽  
Randomized Control ◽  
Coordination Disorder

Objective: To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice. Data sources: We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles. Review methods: Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained. Results: No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for ‘high quality’. Nevertheless, not all included studies were adequately powered for determining an effect. Conclusion: Large effect sizes associated with 95 % confidence intervals suggest that ‘Neuromotor Task Training’, ‘Task-oriented Motor Training’ and ‘Motor Imagery + Task Practice Training’ are the most effective reported interventions for improving motor skills in children with developmental coordination disorder.

scholarly journals A Compendium of Articles Published in International Journal of High Dilution Research from 2008 - 2014

2021 ◽  
Vol 14 (2) ◽  
pp. 62-62
Author(s):  
Saurav Arora
Keyword(s):  
Open Access ◽  
Clinical Research ◽  
Research Evidence ◽  
Basic Research ◽  
Publication Date ◽  
Evidence Based ◽  
High Dilution ◽  
High Quality ◽  
Online Journal ◽  
Meta Analyses

International Journal of High Dilution Research (IJHDR) has served as an important platform for the divulgation of research in the field of high dilution and homeopathy since its foundation in 2008. It is an invaluable resource for researchers, academicians and clinicians being the first open-access, peer-reviewed, online journal specialized in this field. IJHDR is hosted by Groupe International de Recherche sur l’Infinitesimal (GIRI) (www.giriweb.com) and publishes high-quality articles on fundamental/basic research in high dilution, isopathy, biotherapy, nosodes, clinical research/evidence-based homeopathy, veterinary, agronomy, reviews, meta-analyses, systematic reviews, etc. IJHDR believes in making information freely accessible and thus provide free full access to contents as soon as they are published. The IJHDR is currently indexed in databases like LILACS/BIREME/PAHO/WHO; EBSCO; SCOPUS; Qualis/CAPES; Latindex; Google Scholar; DOAJ; NSDL/NSF; Open J-Gate; Journal Seek and Portal CAPES. Since its launching in 2008 until 2014, IJHDR has published 341 articles across 28 issues, including five proceedings of GIRI meetings. With the increasing volume of online published material, the need to preserve it offline has emerged. The present compendium aims to organize the articles published in IJHDR from 2008 – 2014 in one single PDF, which might be saved to any online and offline medium, can be accessed anytime with a few clicks, is searchable and might be printed by libraries and universities for filing in their archives. To facilitate the access, the articles have been arranged as per publication date and hyperlinked to the title. As the present compendium is open access, you might use freely, as well as circulate it among colleagues. The compendium may be download freely from www.highdilution.org/compendium

scholarly journals Acupuncture For Major Depressive Disorder: A Systematic Review and Meta-Analysis of High-Quality Randomized Control Trials

2021 ◽  
Author(s):  
Guixing Xu ◽  
Qiwei Xiao ◽  
Biqing Huang ◽  
Hanzhou Lei ◽  
Zihan Yin ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Sham Acupuncture ◽  
Randomized Control Trials ◽  
High Quality ◽  
Major Depressive ◽  
Quality Of Evidence ◽  
High Quality Evidence ◽  
Randomized Control ◽  
Quality Evidence

Abstract Background: The effects of acupuncture for major depressive disorder (MDD) uncertain. This review aims to determine the effects of Acupuncture for MDD .Methods: Eight Database were searched to identify randomized control trials (RCTs) on Acupuncture for MDD. All RCTs with adult participants undergoing acupuncture treatment for MDD were included. The primary outcome measure was the 24-item Hamilton rating scale for depression (HAMD-24). We used random-effects meta-analysis to synthesis the results with mean difference or odds ratio. Furthermore, the potential heterogeneity was tested through meta-regression/subgroup analyses/sensitive analysis. The quality of evidence for each outcome was assessed by the Grading of Recommendations Assessment, Development and Evaluation approach.Results: Forty-three studies were included: 9 acupuncture versus sham-acupuncture (n=920), 26 acupuncture versus antidepressants (n=2169), 9 acupuncture plus antidepressants versus antidepressants (n=667). Of the 43 high-quality articles, 24 and 8 were determined to have a low and moderate risk of bias, respectively. The pooled results for HAMD-24 and SDS revealed the clinical benefits of Acupuncture or Acupuncture plus antidepressants compared to sham-acupuncture or antidepressants, with high quality evidence. Furthermore, high quality of evidence showed that acupuncture led to fewer adverse effects compared to antidepressants.Conclusions: Acupuncture or acupuncture plus antidepressants were significantly associated with reduced HAMD-24 scores, with high-quality evidence. More rigorous trials are needed to identify the optimal frequency of Acupuncture for MDD and integrate such evidence into clinical care to reduce antidepressant use.

scholarly journals Efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria among children in Africa: a systematic review and meta-analysis of randomized control trials

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dawit Getachew Assefa ◽  
Gizachew Yismaw ◽  
Eyasu Makonnen
Keyword(s):  
Plasmodium Falciparum ◽  
Treatment Failure ◽  
Falciparum Malaria ◽  
Meta Analysis ◽  
Uncomplicated Falciparum Malaria ◽  
Randomized Control Trials ◽  
High Quality ◽  
Quality Of Evidence ◽  
Randomized Control

Abstract Background Emergence of Plasmodium falciparum resistance to artemisinin and its derivatives poses a threat to the global effort to control malaria. The emergence of anti-malarial resistance has become a great public health challenge and continues to be a leading threat to ongoing malaria control efforts. The aim of this review was to synthesize available evidence on the efficacy of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria among children in Africa. Methods A systematic literature search was done to identify relevant articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Central Register of Controlled Trials’ database (CENTRAL) for retrieving randomized control trials comparing efficacy of DHA-PQ and AL for treatment of uncomplicated falciparum malaria in African children. The search was performed from August 2020 to April 2021. Using Rev-Man software (V5.4.1), R-studio and Comprehensive Meta-analysis software version 3, the extracted data from eligible studies were pooled as risk ratio (RR) with 95% confidence interval (CI). Results In this review, 25 studies which involved a total of 13,198 participants were included. PCR-unadjusted treatment failure in children aged between 6 months and 15 years was significantly lower in the DHA-PQ treatment arm on day 28 than that of AL (RR 0.14, 95% CI 0.08–0.26; participants = 1302; studies = 4; I2 = 0%, high quality of evidence). Consistently, the PCR-adjusted treatment failure was significantly lower with DHA-PQ treatment group on day 28 (RR 0.45, 95% CI 0.29–0.68; participants = 8508; studies = 16; I2 = 51%, high quality of evidence) and on day 42 (RR 0.60, 95% CI 0.47–0.78; participants = 5959; studies = 17; I2 = 0%, high quality of evidence). However, the efficacy was ≥ 95% in both treatment groups on day 28. Conclusion From this review, it can be concluded that DHA-PQ reduces new infection and recrudescence on days 28 and 42 more than AL. This may trigger DHA-PQ to become a first-line treatment option.

scholarly journals Safety of dihydroartemisinin-piperaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria among children in Africa: a systematic review and meta-analysis of randomized control trials

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawit Getachew Assefa ◽  
Eden Dagnachew Zeleke ◽  
Wondwosen Molla ◽  
Nebiyu Mengistu ◽  
Ahmedin Sefa ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Meta Analysis ◽  
Plasmodium Falciparum Malaria ◽  
Randomized Control Trials ◽  
High Quality ◽  
Quality Of Evidence ◽  
Online Databases ◽  
Randomized Control ◽  
Comparative Safety

Abstract Background The efficacies of artemisinin based combinations have been excellent in Africa, but also comprehensive evidence regarding their safety would be important. The aim of this review was to synthesize available evidence on the safety of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria among children in Africa. Methods A systematic literature search was done to identify relevant articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Center for Clinical Trial database (CENTRAL) for retrieving randomized control trials comparing safety of DHA-PQ and AL for treatment of uncomplicated P. falciparum malaria among children in Africa. The search was performed from August 2020 to 30 April 2021. Using Rev-Man software (V5.4.1), the extracted data from eligible studies were pooled as risk ratio (RR) with 95% confidence interval (CI). Results In this review, 18 studies were included, which involved 10,498 participants were included. Compared to AL, DHA-PQ was associated with a slightly higher frequency of early vomiting (RR 2.26, 95% CI 1.46 to 3.50; participants = 7796; studies = 10; I2 = 0%, high quality of evidence), cough (RR 1.06, 95% CI 1.01 to 1.11; participants = 8013; studies = 13; I2 = 0%, high quality of evidence), and diarrhoea (RR 1.16, 95% CI 1.03 to 1.31; participants = 6841; studies = 11; I2 = 8%, high quality of evidence) were more frequent in DHA-PQ treatment arm. Conclusion From this review, it can be concluded that early vomiting, diarrhoea, and cough were common were significantly more frequent in patients who were treated with the DHA-PQ than that of AL, and both drugs are well tolerated. More studies comparing AL with DHA-PQ are needed to determine the comparative safety of these drugs.

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