INTRODUCTION Artemisinin-based combination therapies (ACTs) are the first-line antimalarial drugs used to treat uncomplicated Plasmodium falciparum alaria in many endemic countries worldwide. The present work reviewed the therapeutic efficacy of ACT in Cameroon more than 10 years after the initial change in national drug policy in 2004. METHODS A PubMed literature search was performed to analyse clinical trials conducted in Cameroon from 2001 to May 2017. Clinical studies that evaluated ACT for the treatment of uncomplicated falciparum malaria in children or adults, and reported efficacy and/or safety, were included. In addition, a small network meta-analysis (NMA) with a frequentist approach was performed. RESULTS Six papers were selected from 48 articles screened and were full-text reviewed. The efficacy of both artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) ranged from moderate to high, with polymerase chain reaction-corrected cure rates ranging from 96.7 to 100% and 88.2 to 100%, respectively, in per-protocol analysis, and 86.2 to 96.7% and 74.0 to 90.6%, respectively, in intention-to-treat analysis. The malaria evidence network suggested that AL and ASAQ efficacies were comparable. The highest day 3 parasite positivity rate was 8.2% for ASAQ and 4% for AL. A novel ACT, artesunate-atovaquoneproguanil (ASATPG) was tested once and showed a cure rate of 100%. Based on an ITT approach, the NMA revealed that AL was more efficacious than ASAQ, but the difference was not statistical significant (706 participants, three randomised clinical trials (RCT); OR 1.25, 95%CI 0.78-2.00). Adverse events ranged from mild to moderate severity but were not directly attributed to drug intake. CONCLUSION ACTs are still effective and safe in Cameroon; however, there are insufficient data on their efficacy, safety and tolerability, therefore more RCTs should be conducted, including novel ACTs.

中文翻译：

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监测基于青蒿素的联合治疗的疗效和安全性：喀麦隆抗疟治疗功效试验的综述和网络荟萃分析。

引言基于青蒿素的联合疗法（ACT）是一线抗疟药，用于治疗世界各地许多流行国家的单纯性恶性疟原虫。本研究回顾了ACT在2004年国家药物政策的最初变化后超过10年的治疗效果。方法进行PubMed文献检索，以分析2001年至2017年5月在喀麦隆进行的临床试验。包括治疗儿童或成人单纯性恶性疟疾的ACT，并报道了疗效和/或安全性。此外，还进行了一种采用常识性方法的小型网络荟萃分析（NMA）。结果从筛选的48篇文章中选择了六篇论文，并对其进行了全文审查。在每方案分析中，蒿甲醚-卢美他汀（AL）和青蒿琥酯-氨二喹（ASAQ）的疗效从中到高，经聚合酶链反应校正的治愈率分别为96.7％至100％和88.2％至100％在意向性治疗分析中，分别为86.2％至96.7％和74.0％至90.6％。疟疾证据网络表明AL和ASAQ的疗效可比。ASAQ的第3天寄生虫阳性率最高，而AL则为4％。一次测试了一种新的ACT，青蒿琥酯-去氧喹啉鸟嘌呤（ASATPG），其治愈率为100％。根据ITT方法，NMA显示AL比ASAQ更有效，但差异无统计学意义（706名参与者，三项随机临床试验（RCT）； OR 1.25，95％CI 0.78-2.00）。不良事件的严重程度从轻度到中度不等，但并不直接归因于药物摄入。结论喀麦隆的行为仍然有效且安全。但是，关于其功效，安全性和耐受性的数据尚不足，因此应进行更多的RCT，包括新型ACT。