Skip to main content

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