Cochrane · systematic review · CD012656

Primaquine alternative dosing schedules for preventing malaria relapse in people with Plasmodium vivax

Milligan, R, Daher, A, Villanueva, G, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Infectious Diseases2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

14

current version

GRADE rated

10

No studies

0

Included studies

NR

No studies 0 · 0%Ungraded 4 · 28.6%Very low 6 · 42.9%Low 3 · 21.4%Moderate 1 · 7.1%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

Summary of findings table 1 (main comparison)

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB3 (current) · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax parasitaemia	RR 0.96 [0.66, 1.39]	4 studies · 1211 participants	Low Downgraded: risk of bias, imprecision, indirectness
Serious adverse events	no estimate extracted	5 studies · 1427 participants	Ungraded
Adverse events that result in the discontinuation of treatment	RR 1.04 [0.15, 7.38]	5 studies · 1427 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Anaemia or change in haemoglobin status	RR 3 [0.12, 72.91]	1 study · 240 participants	Very low Downgraded: risk of bias, imprecision, indirectness

Summary of findings table 2

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB3 (current) · 3 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax parasitaemia	RR 0.84 [0.49, 1.43]	2 studies · 677 participants	Low Downgraded: risk of bias, imprecision, indirectness
Serious adverse events	no estimate extracted	1 study · 778 participants	Ungraded
Adverse events that result in the discontinuation of treatment	RR 4.19 [0.9, 19.6]	1 study · 778 participants	Very low Downgraded: risk of bias, imprecision, indirectness

Summary of findings table 3

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB3 (current) · 3 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax malaria	RR 3.18 [0.37, 27.6]	1 study · 122 participants	Very low Downgraded: risk of bias, imprecision
Serious adverse events	no estimate extracted	1 study · 129 participants	Ungraded
Anaemia (haemoglobin < 7 g/dL)	no estimate extracted	1 study · 129 participants	Ungraded

Summary of findings table 4

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB3 (current) · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax parasitaemia	RR 1.03 [0.82, 1.3]	2 studies · 2526 participants	Moderate Downgraded: risk of bias, imprecision, indirectness
Serious adverse events	RR 12.03 [1.57, 92.3]	1 study · 1872 participants	Low Downgraded: risk of bias, imprecision
Adverse events the resulted in discontinuation of treatment	RR 2.5 [0.49, 12.87]	2 studies · 2526 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Anaemia	RR 0.93 [0.62, 1.41]	2 studies · 2440 participants	Very low Downgraded: risk of bias, imprecision, indirectness

‘Summary of findings' (main comparison)

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB2 · 6 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax parasitaemia	RR 0.96 [0.66, 1.39]	4 studies · 1211 participants	Low Downgraded: risk of bias, imprecision
Serious adverse effects	no estimate extracted	5 studies · 1427 participants	Ungraded
Adverse events that result in the discontinuation of treatment	RR 1.04 [0.15, 7.38]	4 studies · 1154 participants	Very low Downgraded: risk of bias, imprecision
Adverse effects known to occur with primaquine	RR 1.06 [0.64, 1.76]	4 studies · 1154 participants	Low Downgraded: risk of bias, imprecision
Anaemia or change in haemoglobin status	RR 3 [0.51, 174.01]	1 study · 240 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Adverse events known to occur with chloroquine	RR 9.4 [0.51, 174.01]	1 study · 779 participants	Very low Downgraded: risk of bias, imprecision, indirectness

‘Summary of findings' table 2

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB2 · 6 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax parasitaemia	RR 0.82 [0.47, 1.43]	1 study · 639 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Recurrence of P vivax parasitaemia	RR 1.11 [0.17, 7.09]	1 study · 38 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Serious adverse effects	no estimate extracted	2 studies · 816 participants	Ungraded
Adverse events that result in the discontinuation of treatment	RR 4.19 [0.9, 19.6]	1 study · 778 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Adverse effects known to occur with primaquine	RR 2.72 [0.98, 7.57]	1 study · 778 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Adverse events known to occur with chloroquine	RR 9.43 [0.51, 174.47]	1 study · 778 participants	Very low Downgraded: risk of bias, imprecision, indirectness

‘Summary of findings' table 3

Population: adults and children with confirmed clinical and parasitological P vivax malaria

CD012656.PUB2 · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Recurrence of P vivax malaria	RR 7 [0.38, 127.32]	1 study · 126 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Recurrence of P vivax malaria	RR 3.18 [0.37, 27.6]	1 study · 122 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Serious adverse effects	no estimate extracted	1 study · 129 participants	Ungraded
Anaemia (haemoglobin < 7 g/dL)	no estimate extracted	1 study · 129 participants	Ungraded