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Table 3 Cox regression analysis of risk of recrudescence by day 42

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

Parameter

Patientsa

Eventsa

HR (95 % CI)

P value

Univariable model

 

Day 7 lumefantrine concentration (log2)

    

 Allb

2,528

70

0.64 (0.55 to 0.74)

<0.001

 Venous plasma

1,336

46

0.56 (0.46 to 0.69)

<0.001

 Capillary bloodb

663

21

0.68 (0.54 to 0.84)

0.001

 Venous bloodb

529

3

0.84 (0.16 to 4.34)

0.559

Age (years)

2,528

70

1.01 (0.99 to 1.04)

0.22

Age categoryb

    

  < 1 year

73

2

0.32 (0.06 to 1.59)

0.162

 1–4 years

1,004

29

0.55 (0.23 to 1.31)

0.177

 5–11 years

540

4

0.39 (0.13 to 1.21)

0.103

 12+ years

911

32

Reference

 

Sex (female)

2,528 (1,157)

70 (32)

1.33 (0.82 to 2.16)

0.254

Baseline parasitemia (log10)

2,527

70

1.85 (1.33 to 2.76)

0.003

Baseline temperature (°C)

2,384

56

1.17 (0.93 to 1.46)

0.181

Baseline feverc

2,384 (1,049)

56 (36)

1.49 (0.84 to 2.64)

0.177

Baseline gametocytemia

2,197 (109)

53 (4)

1.69 (0.58 to 4.94)

0.335

Hemoglobinb

2,189

57

1.01 (0.90 to 1.14)

0.857

Moderate anemia

2,279 (1,022)

58 (25)

0.78 (0.44 to 1.39)

0.402

Severe anemia

2,279 (138)

58 (6)

1.23 (0.51 to 2.99)

0.642

WAZ

1,076

34

0.92 (0.70 to 1.21)

0.538

Underweight d

1,076

34

1.36 (0.61 to 3.03)

0.457

Palpable spleen

1,732 (272)

35 (8)

1.25 (0.56 to 2.78)

0.581

Palpable liver

1,732 (102)

35 (5)

1.19 (0.43 to 3.29)

0.732

<Six-dose artemether-lumefantrine regimen

2,528 (142)

70 (15)

5.32 (1.97 to 14.39)

<0.001

D2 Parasite positive count

1,901 (179)

47 (17)

3.12 (1.55 to 6.25)

0.001

D3 Parasite positive count

2,153 (23)

51 (5)

5.29 (1.78 to 15.76)

0.003

Log of PRR48e

1,897

47

0.86 (0.76 to 0.97)

0.011

Early parasitological responsef

    

 Fast

1,193

36

Reference

 

 Slow

65

8

2.98 (1.25 to 7.07)

0.014

 Unknown

1,270

26

1.05 (0.54 to 2.06)

0.879

Transmission intensity areas (TIA)b

    

 Very low

66

9

6.52 (1.28 to 33.23)

0.024

 Low

500

23

1.74 (0.59 to 5.09)

0.314

 Moderate

738

12

0.83 (0.23 to 2.94)

0.769

 High

1,224

26

Reference

 

Multivariable modelg

 

Day 7 lumefantrine concentration (log2)

2,527

70

0.63 (0.54 to 0.73)

<0.001

Baseline parasitemia (log10)

2,527

70

1.87 (1.22 to 2.87)

0.004

Location/transmission intensity area (TIA)

    

 Cambodia

77

10

13.44 (2.51 to 72.02)

0.002

 Very low TIA

66

9

5.63 (1.10 to 28.92)

0.039

 Low TIA

423

13

1.32 (0.34 to 5.07)

0.69

 High/moderate TIA

    

  < 1 year

71

2

0.80 (0.14 to 4.73)

0.807

 1–4 years

973

31

1.37 (0.46 to 4.11)

0.578

 5+ years

917

5

Reference

 

<Six-dose artemether-lumefantrine regimen

2,527

70

4.38 (1.54 to 12.49)

0.006

Early parasitological response

    

 Fast

1,193

36

Reference

 

 Slow

65

8

2.72 (1.04 to 7.16)

0.042

 Unknown

1,269

26

1.02 (0.51 to 2.04)

0.964

  1. aNumbers in brackets refer to patients with the symptom/characteristic present; bP value for testing the proportional hazards assumption <0.05; cfever defined as axillary temperature >37.5 °C; donly evaluated in children <5 years of age and defined as weight-for-age Z-score (WAZ) < −2; ePRR48, parasite reduction rate at 48 hours; fslow early parasitological response was defined as parasite positivity on day 3 or loge of PRR48 < 5 (provided positive count was recorded on day 2); g1 out of 2,528 patients with outcome were excluded from this model due to missing information on baseline parasitemia. TIA, transmission intensity area