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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