Unit-dose packaged drugs for treating malaria.

نویسندگان

  • L Orton
  • G Barnish
چکیده

BACKGROUND Unit-dose packaging of antimalarial drugs may improve malaria cure by making it easier for patients to take their treatment correctly. OBJECTIVES To summarize the effects of unit-dose packaged treatment on cure and treatment adherence in people with uncomplicated malaria. SEARCH STRATEGY We searched the Cochrane Infectious Diseases Group Specialized Register (November 2004), CENTRAL (The Cochrane Library Issue 4, 2004), MEDLINE (1966 to November 2004), EMBASE (1980 to November 2004), LILACS (November 2004), conference proceedings, and reference lists of articles. We also contacted pharmaceutical companies, organizations, and researchers in the field. SELECTION CRITERIA Randomized controlled trials (RCTs), cluster-RCTs, quasi-RCTs, and controlled before-and-after studies of unit-dose packaged drugs for treating uncomplicated malaria. DATA COLLECTION AND ANALYSIS We independently assessed study eligibility and methodological quality, and extracted data for an intention to treat analysis, where possible. We combined binary data using relative risk (RR) and the fixed-effect model, and presented them with 95% confidence intervals (CI). We attempted to contact study authors for additional information. MAIN RESULTS Three quasi-RCTs (895 participants) and one cluster-RCT (6 health facilities) met the inclusion criteria. Trials were of poor methodological quality, and none adequately assessed treatment failure. Unit-dose packaged drugs (in conjunction with prescriber training and patient information) appeared to be associated with higher participant-reported treatment adherence in all trials.A meta-analysis of two trials (596 participants) showed that participant-reported treatment adherence was higher with blister-packed tablets compared with tablets in paper envelopes (RR 1.18, 1.12 to 1.25). Two trials using tablets in sectioned polythene bags as the intervention also noted an increase in participant-reported treatment adherence: the cluster-RCT (6 clusters) compared it with tablets in paper envelopes, and the other trial compared it with syrup in bottles (RR 2.15, 1.76 to 2.61; 299 participants). AUTHORS' CONCLUSIONS There is insufficient evidence to determine the effect of unit-dose packaged antimalarial drugs on treatment failure. Unit-dose packaging supported by prescriber training and patient information appears to improve participant-reported treatment adherence, but these data come from trials with methodological limitations.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Use of weight-for-age-data to optimize tablet strength and dosing regimens for a new fixed-dose artesunate-amodiaquine combination for treating falciparum malaria.

OBJECTIVE To test a novel methodology to define age-based dosing regimens for the treatment of malaria with a new, user-friendly, blister-packaged fixed-dose combination of artesunate and amodiaquine. METHODS A weight-for-age reference database of 88 054 individuals from sub-Saharan Africa was compiled using data from Demographic Health Surveys, observational and intervention studies, and sta...

متن کامل

Clinical Pharmacology of the Antimalarial Quinine in Children

Quinine is the best studied drug for treating severe malaria in very young children. Quinine may be administered in pregnancy and, at therapeutic doses, malformations have not been reported. Some strains of quinine from Southeast Asia and South America have become resistant. Quinine is the treatment of choice for the drug-resistant severe Plasmodium falciparum. The antimalarial mechanism of qui...

متن کامل

Developing artemisinin based drug combinations for the treatment of drug resistant falciparum malaria: A review.

The emergence and spread of drug resistant malaria represents a considerable challenge to controlling malaria. To date, malaria control has relied heavily on a comparatively small number of chemically related drugs, belonging to either the quinoline or the antifolate groups. Only recently have the artemisinin derivatives been used but mostly in south east Asia. Experience has shown that resista...

متن کامل

Development of anti-malaria herbal preparation / drugs from local medicinal plants

1. The screening for potential anti-malaria properties by bioassay guided fractionations. The biological properties were carried out using the plasmodium lactate dehydrogenase assay (pLDH) (Makler, 1993). 2. The harmful effect of the extract was determined by the MTT assay (Mossman, 1983). 3. The extracts were tested for its efficacy in animal model using rodent malaria parasite, P. berghei usi...

متن کامل

Development of anti-malaria herbal preparation / drugs from local medicinal plants

1. The screening for potential anti-malaria properties by bioassay guided fractionations. The biological properties were carried out using the plasmodium lactate dehydrogenase assay (pLDH) (Makler, 1993). 2. The harmful effect of the extract was determined by the MTT assay (Mossman, 1983). 3. The extracts were tested for its efficacy in animal model using rodent malaria parasite, P. berghei usi...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • The Cochrane database of systematic reviews

دوره 2  شماره 

صفحات  -

تاریخ انتشار 2005