Congratulations to the whole team of researchers involved in this
trial. During the past few years a number of studies have been conducted with
quinine and artemether-lumefantrine, but none of the study designs
addressed the primary efficacy endpoint in such a precise manner. However
certain points if considered would have been better for
us to comprehend.
Since the trial is for effectiveness of anti-malarials for treating
uncomplicated falciparum malaria in Ugandan children, it would have been
better if the authors could provide a current picture of incidence of
falciparum malaria in Ugandan children. It would have helped us to
understand the magnitude of the problem.
Again, while discussing exclusion criteria it has been mentioned that
children were not recruited if there was evidence of other concomitant
febrile illness, while in document submitted to clinical trials.gov it
has been mentioned as ’Evidence of a significant concomitant febrile
illness that would require hospitalization or chronic medical illness’(1),
which seems to be better to describe the exclusion criteria.
Since a cost difference exists between quinine and artemether-lumefantrine formulation, a cost-effectiveness study could have been
done simultaneously.
Finally there is a little bit of confusion regarding funding of the
study. In this article, it has been mentioned : This study received
funding from the Department for International Development (DFID), UK,
through the Malaria Consortium (contract No CNTR 04 5432)(2), while the
document submitted to clinical trials .gov declares
the name of sponsors and collaborators as ‘Makerere University.
Ministry of Health, Uganda, Uganda malaria surveillance project.(1)
Again thanks bmj for publishing this research paper
Rapid Response:
Good study
Congratulations to the whole team of researchers involved in this
trial. During the past few years a number of studies have been conducted with
quinine and artemether-lumefantrine, but none of the study designs
addressed the primary efficacy endpoint in such a precise manner. However
certain points if considered would have been better for
us to comprehend.
Since the trial is for effectiveness of anti-malarials for treating
uncomplicated falciparum malaria in Ugandan children, it would have been
better if the authors could provide a current picture of incidence of
falciparum malaria in Ugandan children. It would have helped us to
understand the magnitude of the problem.
Again, while discussing exclusion criteria it has been mentioned that
children were not recruited if there was evidence of other concomitant
febrile illness, while in document submitted to clinical trials.gov it
has been mentioned as ’Evidence of a significant concomitant febrile
illness that would require hospitalization or chronic medical illness’(1),
which seems to be better to describe the exclusion criteria.
Since a cost difference exists between quinine and artemether-lumefantrine formulation, a cost-effectiveness study could have been
done simultaneously.
Finally there is a little bit of confusion regarding funding of the
study. In this article, it has been mentioned : This study received
funding from the Department for International Development (DFID), UK,
through the Malaria Consortium (contract No CNTR 04 5432)(2), while the
document submitted to clinical trials .gov declares
the name of sponsors and collaborators as ‘Makerere University.
Ministry of Health, Uganda, Uganda malaria surveillance project.(1)
Again thanks bmj for publishing this research paper
References
(1) http://clinicaltrials.gov/ct2/show/NCT00540202
(2) BMJ 2009;339:b2763
Competing interests:
None declared
Competing interests: No competing interests