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Table 1 Deviation to WHO protocol and impact on treatment outcome

From: Is there evidence of anti-malarial multidrug resistance in Burkina Faso?

Study setting (Ref) Study design (follow-up) Study pop. (n) ACT Reported % ACPR Deviation from WHO protocol Impact on ACPR
Nouna health centre Aug–Oct 2011 [4] RCT (28 days) 6–59 months (193) ASAQ vs ASAQ + MB 85.1 vs 71.4 mITT analysis, ETF misclassification Decrease
PCR correction with msp1 and msp2 Decrease
Re-infection classified as ACPR Increase
Nouna hospital. OctNov 2016 [5] RCT (28 days) 6–59 months (100) ASAQ + PQ vs ASAQ + MB 95.9 vs 95.7 ITT analysis Decrease
PCR correction with msp1 and msp2 Decrease
Re-infection classified as ACPR Increase
Tiéfora and Mangodara health centres, Comoé Province. Sep–Dec 2009 [6] Single arm (28 days) 6–59 months (105) AL 90.5 PCR correction with msp2 only Decrease
Re-infection classified as ACPR Increase
Tiéfora and Mangodara health centres, Comoé Province. Sep–Dec 2012 [7] Single arm (28 days) 6–59 months (105) AL 86.7 PCR correction with msp2 only Decrease
Re-infection classified as ACPR Increase
Ouagadougou and Nanoro. 2012–2014 [8] Multicentre, multicounty, single arm (28 and 42 days) > 28 days and <5 kg (20) AL 100 day 28-100 day 42a Re-infection classified as ACPR Increase
Colsama and Sakary health centres, Bobo-Dioulasso Jun–Dec 2016 [9] RCT (28 days) > 6 months (281) AL vs ASAQ 85.2 vs 97.0 No PCR correction Decrease
Nanoro health district Sep 2008-Jan 2010 [10] RCT (28 and 42 days) 6–59 months (340) AL vs ASAQ 89.8 vs 89.7 - day 28 66.7 vs 63.0 day 42 PCR correction with msp1 and msp2 Decrease
Re-infection classified as ACPR Increase
Unsupervised treatment Decease
Nanoro health district Sep 2010-Oct 2012 [11,12,13] RCT (28 days) > 6 months (680) AL vs ASAQ 77.8 vs 84.1 PCR correction with msp1 and msp2 Decrease
Re-infection classified as ACPR Increase
Unsupervised treatment Decease
Dafra medical centre, Bobo-Dioulasso Dec 2008-Dec 2010 [14] RCT (42 days) 6 months–15 years
(440)
AL vs ASAQ 91.1 vs 98.1 Longer follow-up Decrease
Re-infection classified as ACPR Increase
Nanoro health district Jun 2010-Aug 2013 [15] Multicentre, multicounty, RCT (63 days) Pregnant women (802) AL vs ASAQ vs ASMQ 93.2 vs 96.7 vs 92.5 Longer follow-up Decrease
Re-infection classified as ACPR Increase
Balinghi. Oct 2010–Oct 2013 [6] Multicentre, multicounty, RCT (63 days) 6–59 months (245) AL vs ASMQ 95.9 vs 97.6 Danger sign classified ETF at day 1 Decrease
Longer follow-up Decrease
Re-infection classified as ACPR Increase
Banfora Oct 2010–Oct 2013 [16] Multicentre, multicounty, RCT (63 days) 6–59 months (115) AL vs ASMQ 94.9 vs 91.2 Danger sign classified ETF at day 1 Decrease
Longer follow-up Decrease
Re-infection classified as ACPR Increase
Ouagadougou and Nanoro Nov 2013-Jun 2015 [17] Multicentre, multicounty, RCT (42 days) 6–12 months (90) DP different formulation 98:3 vs 100b Re-infection classified as ACPR Increase
Bobo Dioulasso and Banfora-Niangoloko Oct 2011–Feb 2016 [18] Multicentre, multicounty, RCT (28 and 42 days) > 6 months (1507) AL vs ASAQ vs ASPY vs DP > 99.5 day 28
98.6 day 42c
Re-infection classified ACPR if failure recorded on last day of follow-up Increase
  1. RCT randomized controlled trial, ACT artemisinin-based combination therapy, AL artemether-lumefantrine, ASAQ artesunate-amodiaquine, ASPY artesunate-pyronaridine, ASMQ artesunate-mefloquine, DP dihydroartemisinin-piperaquine, ACPR adequate clinical and parasitological response, mITT modified intent-to-treat, ITT intent-to-treat, ETF early treatment failure, PCR polymerase chain reaction, msp merozoite surface protein, P. Plasmodium
  2. aData from all sites in Burkina Faso and Benin
  3. bData from all sites in Burkina Faso, The Gambia, Democratic Republic of Congo, Mozambique, Tanzania
  4. cData from all sites in Burkina Faso, Guinea and Mali and for all ACT