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Table 3 Treatment effect on four transmission outcomes:

From: Reduction of transmission from malaria patients by artemisinin combination therapies: a pooled analysis of six randomized trials

Patient-level outcomes (gametocytaemia)
Variable N patients Univariate AUC Ratio of arithmetic means (95% CI) P value N patients Univariate OR slide- positive gametocytaemia on day of feeding (95% CI) P value
Antimalarial       
CQ (non-artemisinin) 240 1 <0.00 337 1 <0.00
SP (non-artemisinin) 325 1.56 (1.27–1.93) 1 520 3.11 (2.19–4.40) 1
CQ-SP (non-artemisinin) 198 1.03 (0.81–1.32)   227 1.33 (0.86–2.06)  
CQ-AS (ACT) 291 0.72 (0.57–0.91)   344 0.42 (0.28–0.62)  
SP-AS3 (ACT) 187 0.62 (0.47–0.83)   581 0.50 (0.32–0.78)  
AL (Coartem) (ACT) 407 0.18 (0.13–0.25)   404 0.15 (0.08–0.29)  
ACT       
non-artemisinin 872 1 <0.00 1201 1 <0.00
ACT 885 0.35 (0.31–0.41) 1 1329 0.20 (0.16–0.26) 1
ACT by pre-treatment gametocytaemia       
day 0 slide-negative     
non-artemisinin 727 1 <0.00 994 1 <0.00
ACT 745 0.23 (0.19–0.28) 1 1125 0.13 (0.10–0.17) 1
day 0 slide-positive       
non-artemisinin 145 1 0.054 164 1  
ACT 140 0.80 (0.64–1.00)   183 0.41 (0.25–0.67) <0.00
ACT by parasitological treatment failure       
No failure      
non-artemisinin 459 1 <0.00 468 1 <0.00
ACT 605 0.31 (0.25–0.37)   615 0.28 (0.20–0.38) 1
Failure      1  
non-artemisinin 269 1 <0.00 303   <0.00
ACT 218 0.51 (0.40–0.65) 1 233 0.33 (0.22–0.49) 1
Mosquito-level outcomes
Variable N mosquito es Adjusted OR mosquito infection (95% CI)* P value N mosquito es Adjusted OR oocyst count per midgut in highest 50% of positive counts (4) (95% CI)* P value
Antimalarial       
CQ (non-artemisinin) 2194 1 0.002 2194 1 <0.00
SP (non-artemisinin) 6762 0.42 (0.20–0.87)   4079 0.25 (0.09–0.75) 1
CQ-SP (non-artemisinin) 1277 1.28 (0.43–3.85)   1146 0.12 (0.03–0.58)  
CQ-AS (ACT) 974 0.28 (0.11–0.71)   974 0.25 (0.05–1.21)  
SP-AS3 (ACT) 2793 0.29 (0.12–0.69)   1439 0.39 (0.09–1.8)  
AL (Coartem) (ACT) 2299 0.22 (0.08–0.61)   292 - 
ACT       
non-artemisinin 11653 1 0.029 7419 1 0.165
ACT 6066 0.49 (0.33–0.73)   2705 0.45 (0.14–1.39)  
ACT by pre-treatment gametocytaemia       
day 0 slide-negative       
non-artemisinin 8811 1 0.002 5700 1 0.008
ACT 4039 0.49 (0.31–0.77)   1419 0.11 (0.02–0.56)  
day 0 slide-positive       
non-artemisinin 2277 1 <0.00 1326 1 0.102
ACT 1870 0.30 (0.16–0.55) 1 1129 0.28 (0.06–1.29)  
ACT by parasitological treatment failure       
No failure       
non-artemisinin 4773 1 0.003 2037 1 0.486
ACT 3496 0.46 (0.28–0.76)   740 0.49 (0.07–3.62)  
Failure       
non-artemisinin 3027 1 0.021 1574 1 0.294
ACT 897 0.37 (0.16–0.86)   572 0.33 (0.04–2.59)  
  1. at the patient level, the area under the curve of gametocyte density (microscopy measurement) during follow up (28 days), the presence of slide-positive gametocytaemia on the day of feeding; at the mosquito level, the presence of infection in mosquitoes, and high density infection in mosquitoes.
  2. * adjusted for type of serum (autologous/control) used in transmission experiment
  3. † P interaction with ACT/non-artemisinin <0.05
  4. ‡ Mosquitoes were infected only in study 6 where oocyst data was not collected, except one mosquito in study 5 which had a missing oocyst count.