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Abstract：
BACKGROUND: Chemoprophylaxis is a prevention method for malaria during travel in malaria-endemic countries. This study aimed to collate and synthesize the evidence of malarial chemoprophylaxis among malaria death cases.
METHODS: Studies documenting malarial chemoprophylaxis related to malaria deaths were searched in PubMed, Scopus, MEDLINE, Embase, and CENTRAL until 3 July 2022. The pooled proportion of malarial chemoprophylaxis among death cases was synthesized using logit transformation and back transformation to a proportion performed using generalized linear mixed models. The pooled log odds ratio (log-OR) with a 95% confidence interval (CI) of malarial chemoprophylaxis in death cases compared to survivors were synthesized.
RESULTS: Fifty-eight studies were included in the systematic review and the meta-analysis. Of 602 pooled malaria death cases, the number of patients who took chemoprophylaxis was 187 (30%) (95% CI 22-40, P < 0.01, 58 studies), and those who took adequate chemoprophylaxis were 24 (5%) (95% CI 2-13, P < 0.01, 42 studies). A comparable log-OR of underwent chemoprophylaxis was observed between malaria death cases and survivors (P = 0.94, pooled log-OR: - 0.02, 95% CI - 0.46-0.42, I2: 0%, 17 studies). Similarly, a comparable log-OR of adequate chemoprophylaxis was identified between malaria death cases and survivors (P = 0.15, pooled log-OR: 0.83, 95% CI - 0.30-1.97, I2: 47.08%, 11 studies).
CONCLUSIONS: Among the studies where malarial chemoprophylaxis was reported, approximately 30% of malaria death cases had taken such prophylaxis. Notably, only 5% of these cases adhered fully or adequately to the recommended chemoprophylactic regimen. However, the analysis did not reveal a significant difference in the odds of malarial chemoprophylaxis between malaria death cases and survivors.
METHODS: Studies documenting malarial chemoprophylaxis related to malaria deaths were searched in PubMed, Scopus, MEDLINE, Embase, and CENTRAL until 3 July 2022. The pooled proportion of malarial chemoprophylaxis among death cases was synthesized using logit transformation and back transformation to a proportion performed using generalized linear mixed models. The pooled log odds ratio (log-OR) with a 95% confidence interval (CI) of malarial chemoprophylaxis in death cases compared to survivors were synthesized.
RESULTS: Fifty-eight studies were included in the systematic review and the meta-analysis. Of 602 pooled malaria death cases, the number of patients who took chemoprophylaxis was 187 (30%) (95% CI 22-40, P < 0.01, 58 studies), and those who took adequate chemoprophylaxis were 24 (5%) (95% CI 2-13, P < 0.01, 42 studies). A comparable log-OR of underwent chemoprophylaxis was observed between malaria death cases and survivors (P = 0.94, pooled log-OR: - 0.02, 95% CI - 0.46-0.42, I2: 0%, 17 studies). Similarly, a comparable log-OR of adequate chemoprophylaxis was identified between malaria death cases and survivors (P = 0.15, pooled log-OR: 0.83, 95% CI - 0.30-1.97, I2: 47.08%, 11 studies).
CONCLUSIONS: Among the studies where malarial chemoprophylaxis was reported, approximately 30% of malaria death cases had taken such prophylaxis. Notably, only 5% of these cases adhered fully or adequately to the recommended chemoprophylactic regimen. However, the analysis did not reveal a significant difference in the odds of malarial chemoprophylaxis between malaria death cases and survivors.
摘要：
背景：化学预防是疟疾流行国家旅行期间疟疾的一种预防方法。这项研究旨在整理和综合疟疾死亡病例中疟疾化学预防的证据。
方法：在PubMed中搜索了记录与疟疾死亡相关的疟疾化学预防的研究，Scopus,MEDLINE,Embase,和中央至2022年7月3日。使用logit变换和反变换将死亡病例中疟疾化学预防的合并比例合成为使用广义线性混合模型进行的比例。合成了与幸存者相比，死亡病例中疟疾化学预防的合并对数比值比（log-OR）和95％置信区间（CI）。
结果：58项研究纳入系统评价和荟萃分析。在602例疟疾死亡病例中，接受化学预防的患者人数为187（30％）（95％CI22-40，P<0.01，58项研究），采取适当化学预防的患者为24（5％）（95％CI2-13，P<0.01，42项研究）。在疟疾死亡病例和幸存者之间观察到接受化学预防的对数OR（P=0.94，汇总对数OR：-0.02，95％CI-0.46-0.42，I2：0％，17项研究)。同样，在疟疾死亡病例和幸存者之间确定了可比较的适当化学预防的log-OR（P=0.15，汇总log-OR：0.83，95％CI-0.30-1.97，I2：47.08％，11项研究)。
结论：在报告疟疾化学预防的研究中，约30%的疟疾死亡病例采取了此类预防措施.值得注意的是,这些病例中只有5%完全或充分遵守了推荐的化学预防方案.然而,该分析未发现疟疾死亡病例和幸存者之间的疟疾化学预防几率存在显著差异.
方法：在PubMed中搜索了记录与疟疾死亡相关的疟疾化学预防的研究，Scopus,MEDLINE,Embase,和中央至2022年7月3日。使用logit变换和反变换将死亡病例中疟疾化学预防的合并比例合成为使用广义线性混合模型进行的比例。合成了与幸存者相比，死亡病例中疟疾化学预防的合并对数比值比（log-OR）和95％置信区间（CI）。
结果：58项研究纳入系统评价和荟萃分析。在602例疟疾死亡病例中，接受化学预防的患者人数为187（30％）（95％CI22-40，P<0.01，58项研究），采取适当化学预防的患者为24（5％）（95％CI2-13，P<0.01，42项研究）。在疟疾死亡病例和幸存者之间观察到接受化学预防的对数OR（P=0.94，汇总对数OR：-0.02，95％CI-0.46-0.42，I2：0％，17项研究)。同样，在疟疾死亡病例和幸存者之间确定了可比较的适当化学预防的log-OR（P=0.15，汇总log-OR：0.83，95％CI-0.30-1.97，I2：47.08％，11项研究)。
结论：在报告疟疾化学预防的研究中，约30%的疟疾死亡病例采取了此类预防措施.值得注意的是,这些病例中只有5%完全或充分遵守了推荐的化学预防方案.然而,该分析未发现疟疾死亡病例和幸存者之间的疟疾化学预防几率存在显著差异.
