Safety and effectiveness of antimalarial therapy in sickle cell disease: a systematic review and network meta-analysis

Existing Reviews

Please note, new claims can take a short while to show up.

No claims yet.

Annotation Summary

Term Occurence Count Dictionary
Mefloquine 10 infectiousdiseasesdrugs
malaria 60 infectiousdiseases
pyrimethamine 6 infectiousdiseasesdrugs

Graph of close proximity drug and disease terms (within 200 characters).

Note: If this graph is empty, then there are no terms that meet the proximity constraint.

Review

Having read the paper, please pick a pair of statements from the paper to indicate that a drug and disease are related.

Select Drug Character Offset Drug Term Instance
Mefloquine 1801 chemoprophylaxis in SCD children were identified. In total, seven different interventions (Chloroquine, Mefloquine , Mefloquine artesunate, Proguanil, Pyrimethamine, Sulfadoxine-pyrimethamine, Sulfadoxine-pyrimethamine
Mefloquine 1813 in SCD children were identified. In total, seven different interventions (Chloroquine, Mefloquine, Mefloquine artesunate, Proguanil, Pyrimethamine, Sulfadoxine-pyrimethamine, Sulfadoxine-pyrimethamine amodiaquine)
Mefloquine 10633 following seven chemoprophylactic regimens [(a) Proguanil (PG); (b) Sulphadoxine-Pyrimethamine (SP); (c) Mefloquine (MQ); (d) Chloroquine (CQ); (e) Pyrimethamine (PM); (f) Mefloquine-Artesunate (MQAS); and (g) Sulphadoxine-Pyrimethamine-Amodiaquine
Mefloquine 10700 Sulphadoxine-Pyrimethamine (SP); (c) Mefloquine (MQ); (d) Chloroquine (CQ); (e) Pyrimethamine (PM); (f) Mefloquine -Artesunate (MQAS); and (g) Sulphadoxine-Pyrimethamine-Amodiaquine (SPAQ)] were evaluated in the meta-analysis.
Mefloquine 12566 1965Uganda21PL66SSNA31.82None68.18CQ + benzathine penicillin60NA11.67None88.33CQ = Chloroquine, MQ = Mefloquine , MQAS = Mefloquine-artesunate, NA = Not available, PL = Placebo, PG = Proguanil, PM = Pyrimethamine,
Mefloquine 12589 1965Uganda21PL66SSNA31.82None68.18CQ + benzathine penicillin60NA11.67None88.33CQ = Chloroquine, MQ = Mefloquine, MQAS = Mefloquine -artesunate, NA = Not available, PL = Placebo, PG = Proguanil, PM = Pyrimethamine, SP=Sulfadoxine-pyrimethamine,
Mefloquine 13806 UgandaPLCQ + benzathine penicillinYesYesNot providedYesaNo (dactylitis and Haemoglobin)CQ = Chloroquine, MQ = Mefloquine , MQAS = Mefloquine-artesunate, PL = Placebo, PG = Proguanil, SP=Sulfadoxine-pyrimethamine,
Mefloquine 13829 penicillinYesYesNot providedYesaNo (dactylitis and Haemoglobin)CQ = Chloroquine, MQ = Mefloquine, MQAS = Mefloquine -artesunate, PL = Placebo, PG = Proguanil, SP=Sulfadoxine-pyrimethamine, SPAQ = Sulfadoxine
Mefloquine 25795 the point estimates and standard errors. SP=Sulfadoxine-Pyrimethamine, CQ = Chloroquine, MQ = Mefloquine , PG = Proguanil, PM = Pyrimethamine, PL = Placebo, MQAS = Mefloquine-Artesunate, SPAQ = Sulfadoxine
Mefloquine 25880 CQ = Chloroquine, MQ = Mefloquine, PG = Proguanil, PM = Pyrimethamine, PL = Placebo, MQAS = Mefloquine -Artesunate, SPAQ = Sulfadoxine Pyrimethamine-Amodiaquine. (DOCX 28 kb)Additional file 2:Table S1.
pyrimethamine 1874 interventions (Chloroquine, Mefloquine, Mefloquine artesunate, Proguanil, Pyrimethamine, Sulfadoxine- pyrimethamine , Sulfadoxine-pyrimethamine amodiaquine) were evaluated in 912 children with SCD. Overall, the meta-analysis
pyrimethamine 1901 Mefloquine, Mefloquine artesunate, Proguanil, Pyrimethamine, Sulfadoxine-pyrimethamine, Sulfadoxine- pyrimethamine amodiaquine) were evaluated in 912 children with SCD. Overall, the meta-analysis showed that antimalarial
pyrimethamine 12713 NA = Not available, PL = Placebo, PG = Proguanil, PM = Pyrimethamine, SP=Sulfadoxine- pyrimethamine , SPAQ = Sulfadoxine pyrimethamine-amodiaquine, SS = homozygous sickle haemoglobinTable 2Assessment
pyrimethamine 12751 PL = Placebo, PG = Proguanil, PM = Pyrimethamine, SP=Sulfadoxine-pyrimethamine, SPAQ = Sulfadoxine pyrimethamine -amodiaquine, SS = homozygous sickle haemoglobinTable 2Assessment of risk of bias of studies included
pyrimethamine 13905 MQ = Mefloquine, MQAS = Mefloquine-artesunate, PL = Placebo, PG = Proguanil, SP=Sulfadoxine- pyrimethamine , SPAQ = Sulfadoxine pyrimethamine-amodiaquineaYes indicates that there is no evidence of incomplete
pyrimethamine 13943 MQAS = Mefloquine-artesunate, PL = Placebo, PG = Proguanil, SP=Sulfadoxine-pyrimethamine, SPAQ = Sulfadoxine pyrimethamine -amodiaquineaYes indicates that there is no evidence of incomplete outcome data recordingb Yes indicates
Select Disease Character Offset Disease Term Instance
malaria 62 Title: BMC Infectious DiseasesSafety and effectiveness of anti malaria l therapy in sickle cell disease: a systematic review and network meta-analysisAugustina FrimpongLaty
malaria 477 of all reported sickle cell disease (SCD) cases in children anually are recorded in Africa. Although malaria is considered a major cause of death in SCD children, there is limited data on the safety and effectiveness
malaria 614 of death in SCD children, there is limited data on the safety and effectiveness of the available anti malaria l drugs used for prophylaxis. Also, previous systematic reviews have not provided quantitative measures
malaria 913 review and meta-analysis of the available literature to determine the safety and effectiveness of anti malaria l chemoprophylaxis used in SCD patients.MethodsWe searched in PubMed, Medline, CINAHL, POPLine and Cochrane
malaria 1170 1990 to April 2018. We considered randomized or quasi-randomized controlled trials comparing any anti malaria l chemoprophylaxis to, 1) other antimalarial chemoprophylaxis, 2) placebo or 3) no intervention, in SCD
malaria 1213 or quasi-randomized controlled trials comparing any antimalarial chemoprophylaxis to, 1) other anti malaria l chemoprophylaxis, 2) placebo or 3) no intervention, in SCD patients. Studies comparing at least two
malaria 1688 heterogeneity assessed using the I-square.ResultsSix qualified studies that highlighted the importance of anti malaria l chemoprophylaxis in SCD children were identified. In total, seven different interventions (Chloroquine,
malaria 2012 Sulfadoxine-pyrimethamine amodiaquine) were evaluated in 912 children with SCD. Overall, the meta-analysis showed that anti malaria l chemoprophylaxis provided protection against parasitemia and clinical malaria episodes in children
malaria 2091 meta-analysis showed that antimalarial chemoprophylaxis provided protection against parasitemia and clinical malaria episodes in children with SCD. Nevertheless, the risk of hospitalization (OR = 0.72, 95% CI = 0.267–1.959;
malaria 2559 I2 = 0.0%) did not differ between the intervention and placebo groups.ConclusionThe data shows that anti malaria l prophylaxis reduces the incidence of clinical malaria in children with SCD. However, there was no difference
malaria 2614 placebo groups.ConclusionThe data shows that antimalarial prophylaxis reduces the incidence of clinical malaria in children with SCD. However, there was no difference between the occurrence of adverse events in children
malaria 2849 placebo and those who received prophylaxis. This creates an urgent need to assess the efficacy of new anti malaria l drug regimens as potential prophylactic agents in SCD patients.Systematic review registrationPROSPERO
malaria 3889 undiagnosed infants in sub-Saharan Africa, and is predominantly attributed to infections, including malaria [[3]]. Although a linkage exists between the presence of sickle haemoglobin (HbS) and protection from
malaria 3999 [[3]]. Although a linkage exists between the presence of sickle haemoglobin (HbS) and protection from malaria in the heterozygous state [[4]], malaria is a frequent cause of hospitalization and poor outcome among
malaria 4040 the presence of sickle haemoglobin (HbS) and protection from malaria in the heterozygous state [[4]], malaria is a frequent cause of hospitalization and poor outcome among children with SCD in endemic areas [[5],
malaria 4161 cause of hospitalization and poor outcome among children with SCD in endemic areas [[5], [6]], and malaria is associated with a higher mortality in hospitalized SCD patients compared to hospitalized non-SCD
malaria 4311 hospitalized SCD patients compared to hospitalized non-SCD patients [[7]–[9]]. Prophylaxis against malaria is therefore important in SCD patients, as antimalarial chemoprophylaxis has also been shown to be beneficial
malaria 4366 non-SCD patients [[7]–[9]]. Prophylaxis against malaria is therefore important in SCD patients, as anti malaria l chemoprophylaxis has also been shown to be beneficial in SCD patients, reducing parasitaemia and anaemia,
malaria 4610 transfusion [[10]–[12]].The WHO recommends that SCD patients in endemic areas should receive anti malaria l prophylaxis [[13], [14]]; however, the evidence to support the potential beneficial effects of this
malaria 5270 regimens are the treatment standard. There is also lack of data on the comparative effect of different anti malaria l chemoprophylactic regimens that have never been compared directly in randomized clinical trials, and
malaria 6056 selection criteriaWe considered randomized or quasi-randomized controlled trials comparing any anti malaria l chemoprophylactics to, 1) other antimalarial chemoprophylactics, 2) placebo or 3) no intervention,
malaria 6101 or quasi-randomized controlled trials comparing any antimalarial chemoprophylactics to, 1) other anti malaria l chemoprophylactics, 2) placebo or 3) no intervention, in SCD patients. The selection included studies
malaria 6616 2018. The MeSH terms for the search included a combination of the following terms, sickle cell disease, malaria , malaria chemoprophylaxis, chemoprophylactics, malaria chemotherapy(y)ies, mortality, hospitalization,
malaria 6625 MeSH terms for the search included a combination of the following terms, sickle cell disease, malaria, malaria chemoprophylaxis, chemoprophylactics, malaria chemotherapy(y)ies, mortality, hospitalization, morbidity,
malaria 6671 of the following terms, sickle cell disease, malaria, malaria chemoprophylaxis, chemoprophylactics, malaria chemotherapy(y)ies, mortality, hospitalization, morbidity, effectiveness of, antimalarial therapy, antimalarial
malaria 6760 chemoprophylactics, malaria chemotherapy(y)ies, mortality, hospitalization, morbidity, effectiveness of, anti malaria l therapy, antimalarial drugs, malaria therapy, malaria treatment, malaria prophylaxis, safety of, safety
malaria 6782 chemotherapy(y)ies, mortality, hospitalization, morbidity, effectiveness of, antimalarial therapy, anti malaria l drugs, malaria therapy, malaria treatment, malaria prophylaxis, safety of, safety and effectiveness,
malaria 6798 mortality, hospitalization, morbidity, effectiveness of, antimalarial therapy, antimalarial drugs, malaria therapy, malaria treatment, malaria prophylaxis, safety of, safety and effectiveness, randomized trials,
malaria 6815 hospitalization, morbidity, effectiveness of, antimalarial therapy, antimalarial drugs, malaria therapy, malaria treatment, malaria prophylaxis, safety of, safety and effectiveness, randomized trials, randomized control
malaria 6834 morbidity, effectiveness of, antimalarial therapy, antimalarial drugs, malaria therapy, malaria treatment, malaria prophylaxis, safety of, safety and effectiveness, randomized trials, randomized control trials, quasi-randomized
malaria 8324 Risk of Bias tool, identifying the presence or otherwise of key concepts or themes relating to anti malaria l intervention trials including, random sequence generation, allocation concealment, blinding of participants,
malaria 8651 measuresThe pre-specified primary outcome measures were, 1) safety and 2) effectiveness of the anti malaria l chemoprophylactics for SCD patients. Safety was defined as, the ability of the intervention to minimize
malaria 8994 of the intervention a) to decrease detectable parasitaemia and/or b) to limit the number of clinical malaria episodes. Other outcome measures included mortality as associated with a clinical malaria episode, or
malaria 9084 clinical malaria episodes. Other outcome measures included mortality as associated with a clinical malaria episode, or vaso-occlusive crisis (VOC), and the number of VOC episodes.Statistical analysisThe Comprehensive
malaria 11606 an adequate blinding procedure (Table 2).Fig. 1PRISMA flow chart for the systematic review of anti malaria l drugs used for preventing malaria in sickle cell disease (SCD) patientsTable 1Characteristics of studies
malaria 11641 (Table 2).Fig. 1PRISMA flow chart for the systematic review of antimalarial drugs used for preventing malaria in sickle cell disease (SCD) patientsTable 1Characteristics of studies included in this systematic review
malaria 11908 (months)Drug regimenNo. of participantsGenotypeAdverse events (%)Patients with detectable parasitaemia and/or malaria clinical episodes (%)No. of deathsSuccess rate (95% CI)Olaosebikan et al., 2015Nigeria14MQAS90SS/SC247.78461%
malaria 15501 represent the number of participants included in the intervention groupsParasitaemia and/or clinical malaria episodesAll the included studies provided data on the number of clinical malaria episodes and/or the
malaria 15582 groupsParasitaemia and/or clinical malaria episodesAll the included studies provided data on the number of clinical malaria episodes and/or the number of patients presenting with detectable parasitaemia during the follow-up
malaria 15965 receiving prophylaxis were less likely to harbour detectable parasitaemia or to present with a clinical malaria episode compared to the placebo group (relative risk reduction of 24%) (Fig. 3). Taken individually,
malaria 16308 S1).Fig. 3Summary plot showing the effectiveness of the chemoprophylaxis with placebo as a reference. Anti malaria l drugs were compared to placebo with the risk of developing malaria. Each single drug was represented
malaria 16376 with placebo as a reference. Antimalarial drugs were compared to placebo with the risk of developing malaria . Each single drug was represented as a square. The square area denotes the contribution of the drug
malaria 18451 risk rate (Fig. 4d).Fig. 4Forest plots showing the commonly reported adverse-events related to the anti malaria chemoprophylaxis in SCD patients. Results are shown for (a) hospitalization, (b) blood transfusion,
malaria 19376 systematic review has provided an opportunity to provide quantitative data on the safety and efficacy of anti malaria l prophylactic drugs in SCD patients, thus extending the available summary evidence on this indication.
malaria 19615 component has also enabled a comparison of all active comparator drugs used in clinical trials of anti malaria l prophylaxis in SCD to date, thus, increasing the chances of generating an internally consistent set
malaria 20092 efficacy and safety of individual interventions.The results from this meta-analysis shows that anti- malaria l chemoprophylaxis provided protection against parasitemia and clinical malaria episodes in children
malaria 20171 meta-analysis shows that anti-malarial chemoprophylaxis provided protection against parasitemia and clinical malaria episodes in children with SCD. However, the results show that the intervention did not have an effect
malaria 20685 the recommended IPT for SCD patients. In addition, it could be due to the relative safety of this anti malaria l drug [[24]], an important characteristic in such a vulnerable target group and for such an indication.
malaria 21555 that the development of VOC requires the interplay of various factors [[28]], it may be exacerbated by malaria infection. However most of these studies were conducted in the era preceding the evolution of widespread
malaria 21692 these studies were conducted in the era preceding the evolution of widespread resistance to these anti malaria l drugs.Due to this, the use of anti-malarial monotherapies as prophylaxis in a group as vulnerable as
malaria 21736 preceding the evolution of widespread resistance to these antimalarial drugs.Due to this, the use of anti- malaria l monotherapies as prophylaxis in a group as vulnerable as sickle cell disease patients is of utmost
malaria 22363 HbAA genotypes [[33], [34]]. Therefore, it is imperative that new studies with currently available anti malaria l prophylactic drugs be conducted in SCD patients.Also, the meta-analysis data showed a higher MQ-related
malaria 23514 with ACTs in these groups of children. However, as concluded by a recent systematic review on ACTs and malaria in haemoglobinopathies, the efficacy of these ACTs when used as prophylaxis in haemoglobinopathies is
malaria 23734 proven [[38]]. This implies that, there is still limited evidence on the safety and efficacy of anti malaria l prophylaxis in SCD patients and therefore, highly recommended that new antimalarial drugs should be
malaria 23818 efficacy of antimalarial prophylaxis in SCD patients and therefore, highly recommended that new anti malaria l drugs should be evaluated for their efficacy and safety specifically in SCD patients.The limitations
malaria 24522 These may have also accounted for the lack of association between safety parameter outcomes and anti malaria l prophylaxis observed in the analysis.ConclusionThe data shows that the use of antimalarial drugs as
malaria 24613 and antimalarial prophylaxis observed in the analysis.ConclusionThe data shows that the use of anti malaria l drugs as prophylaxis in sickle cell disease patients results in reduction in incidence of malaria;
malaria 24712 antimalarial drugs as prophylaxis in sickle cell disease patients results in reduction in incidence of malaria ; whereas the incidence of hospitalisation, blood transfusion, vaso-occlusive crises and mortality were
malaria 25244 vaso-occlusive crises.The findings indicate that there is non-existent data on currently recommended anti malaria l drugs as prophylaxis in SCD patients thus, there is a need to evaluate the safety and efficacy of new
malaria 25359 as prophylaxis in SCD patients thus, there is a need to evaluate the safety and efficacy of new anti malaria l drugs including the utility of currently recommended ACT regimens, as potential prophylactic agents

You must be authorized to submit a review.