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Table 2 Determinants of day 7 lumefantrine concentrations in non-pregnant patients treated with the six-dose artemether-lumefantrine regimen

From: Artemether-lumefantrine treatment of uncomplicated Plasmodium falciparum malaria: a systematic review and meta-analysis of day 7 lumefantrine concentrations and therapeutic response using individual patient data

 

N (n)a

Change (%) (95 % CI)

P value

Univariable model

Dose (mg/kg)

2,551

0.3 (0.1 to 0.6)

0.010

Co-administration with fat

2,574 (2,185)

−1.0 (−28.2 to 26.2)

0.943

Unsupervised administrationb

2,574 (816)

−45.4 (−50.6 to −39.6)

<0.001

Age

   

  < 1 year

82

−37.7 (−50.5 to −21.6)

<0.001

 1–2 years

562

−46.5 (−53.5 to −38.5)

<0.001

 3–4 years

597

−26.1(−35.7 to −15.1)

<0.001

 5–11 years

534

−3.4 (−12.6 to 6.9)

0.507

 12+ years

799

Reference

 

Sample matrix

   

 Capillary bloodc

848

−38.2 (−54.0 to −22.4)

<0.001

 Venous bloodc

544

18.5 (−34.7 to 71.8)

0.458

 Venous plasma

1,182

Reference

 

Day of samplingd

2,574

−36.8 (−56.6 to −17.0)

0.004

Fevere

2,426 (1,054)

−17.4 (−24.0 to −10.8)

<0.001

Hemoglobinf

2,200

1.0 (−0.8 to 2.8)

0.272

Baseline parasitemia (log10)

2,554

−8.8 (−13.3 to −4.1)

<0.001

WAZg

1,240

3.2 (−1.7 to 8.0)

0.191

UWAh

1,240 (215)

−4.5 (−19.1 to 10.2)

0.559

Multivariable modeli

Dose (mg/kg)

2,422

0.5 (0.2 to 0.7)

0.001

Unsupervised administrationb

2,422 (795)

−43.8 (−49.1 to −38.0)

<0.001

Day of samplingd

2,422

−36.4 (−53.6 to −12.9)

0.005

Fevere

2,422 (1,052)

−13.5 (−20.1 to −6.4)

<0.001

Baseline parasitemia (log10)

2,422

−5.1 (−9.8 to −0.1)

0.045

Age

   

  < 1 year

82

−38.1 (−51.1 to −21.7)

<0.001

 1–2 years

555

−41.4 (−48.9 to −32.7)

<0.001

 3–4 years

594

−20.9 (−30.9 to −9.4)

0.001

 5–11 years

508

−6.6 (−16.1 to 4.0)

0.215

 12+ years

683

Reference

 

Multivariable model – supervised administration onlyj

Dose (mg/kg)

1,562

0.4 (0.1 to 0.7)

0.007

Day of samplingd

1,562

−43.0 (−60.1 to −18.6)

0.001

Sample matrixk

   

 Capillary bloodc

366

−15.2 (−31.0 to 4.3)

0.119

 Venous bloodc

541

1.4 (−23.2 to 34.0)

0.921

 Venous plasma

655

Reference

 

Hemoglobin

   

 Capillary bloodc

366

−5.4 (−9.0 to −1.7)

0.005

 Venous bloodc

541

2.4 (−1.5 to 6.4)

0.229

 Venous plasma

655

−1.8 (−4.2 to 0.7)

0.163

Fevere

1,562 (590)

−12.2 (−19.3 to −4.4)

0.003

Baseline parasitemia (log10)

1,562

−6.1 (−10.7 to −1.4)

0.012

Age

   

  < 3 years old UWAh

28

−52.8 (−65.0 to −36.5)

<0.001

 Not UWA

262

−38.6 (−47.5 to −28.2)

<0.001

 3–4 years old UWAh

48

−19.5 (−35.8 to 1.0)

0.061

 Not UWA

229

−17.5 (−29.4 to −3.6)

0.015

 5–11 years old

399

−2.0 (−11.5 to 8.5)

0.881

  ≥ 12 years old

596

Reference

 
  1. aN, total number of patients with non-missing data; n, number of patients with this characteristic; bunsupervised administration includes five studies with no supervised doses and two studies with the three morning doses supervised; ccollected on filtered paper; dper day, evaluated between days 6 and 8; edefined as axillary temperature >37.5 °C on enrolment; fno statistically significant association was found when stratified by sample matrix; P for interaction = 0.435; gWorld Health Organization (WHO) Child Growth Standards weight-for-age Z-score (WAZ) in children <5 years of age; hdefined using a WAZ < −2 in children <5 years of age; i151 out of 2,574 patients were excluded from this model due to missing information on dose (23) and fever (148); j131 out of 1,758 patients with supervised treatment were excluded from this model due to missing information on dose (3), fever (127), UWA status (1) or hemoglobin (65); kcomparison at mean value of hemoglobin of 11 g/dL