Intervention Review

Unit-dose packaged drugs for treating malaria

  1. Lois C Orton1,*,
  2. Guy Barnish2

Editorial Group: Cochrane Infectious Diseases Group

Published Online: 20 APR 2005

Assessed as up-to-date: 24 MAR 2009

DOI: 10.1002/14651858.CD004614.pub2

How to Cite

Orton LC, Barnish G. Unit-dose packaged drugs for treating malaria. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD004614. DOI: 10.1002/14651858.CD004614.pub2.

Author Information

  1. 1

    University of Manchester, School of Nursing, Midwifery and Social Work, Manchester, UK

  2. 2

    Liverpool School of Tropical Medicine, Disease Control Strategy Group, Liverpool, Merseyside, UK

*Lois C Orton, School of Nursing, Midwifery and Social Work, University of Manchester, University Place, Oxford Road, Manchester, M13 9PL, UK.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 20 APR 2005




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要


Unit-dose packaging of antimalarial drugs may improve the success of malaria treatments by making it easier for patients to take them correctly.


To summarize the effects of unit-dose packaged treatment on treatment failure and treatment adherence in people with uncomplicated malaria.

Search methods

We searched the Cochrane Infectious Diseases Group Specialized Register (February 2009); CENTRAL (The Cochrane Library Issue 1, 2009); MEDLINE (1966 to February 2009); EMBASE (1980 to February 2009); LILACS (February 2009); conference proceedings, and reference lists of articles. We also contacted pharmaceutical companies, organizations, and researchers in the field.

Selection criteria

Randomized controlled trials (RCTs), cluster-RCTs and quasi-RCTs of unit-dose packaged drugs for treating uncomplicated malaria.

Data collection and analysis

We independently assessed trial eligibility and risk of bias, and extracted data for an intention-to-treat analysis, where possible. We combined binary data using risk ratio (RR) and the fixed-effect model, and presented them with 95% confidence intervals (CI). We attempted to contact trial authors for additional information.

Main results

One RCT (203 participants), three quasi-RCTs (895 participants), and one cluster-RCT (six health facilities) met the inclusion criteria. Trials were generally of poor methodological quality, and none adequately assessed treatment failure. Unit-dose packaged drugs (in conjunction with prescriber training and patient information) appeared to be associated with higher participant-reported treatment adherence in all trials.

A meta-analysis of two trials (596 participants) showed that participant-reported treatment adherence was slightly higher with blister-packed tablets compared with tablets in paper envelopes (RR 1.18, 95% CI 1.12 to 1.25). Two trials using tablets in sectioned polythene bags as the intervention also noted an increase in participant-reported treatment adherence: the cluster-RCT (six clusters) compared it with tablets in paper envelopes, and the other trial compared it with syrup in bottles (RR 2.15, 95% CI 1.76 to 2.61; 299 participants).

Authors' conclusions

There is insufficient evidence to know if the effects of unit-dose packaged antimalarial drugs reduce treatment failure. Unit-dose packaging, supported by prescriber training and patient information, appears to improve participant-reported treatment adherence, but these data come from trials with methodological limitations.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Unit-dose packaging of drugs for treating malaria

Malaria is a parasitic disease spread by mosquitoes in areas such as sub-Saharan Africa, South-East Asia and South America. Millions of people are infected with malaria each year. It is thought that packaging a course of treatment in units of a single dose may better ensure the correct dosage is taken, thus increasing the success of treatment. The review found insufficient good quality evidence from randomized controlled trials to determine if unit-dose packaging of drugs saves lives, but there is some indication that it might improve treatment adherence. More research is needed.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要







我們搜尋Cochrane Infectious Diseases Group Specialized Register (2004年11月)、 CENTRAL (Cochrane Library Issue 4, 2004)、 MEDLINE (1966年−2004年11月)、 EMBASE (1980年 – 2004年11月)、 LILACS (2004年11月)、研討會手冊,以及文章的參考資料清單。我們也與本領域藥廠、相關機構以及研究人員聯絡。






有3項半隨機對照試驗(895名參與者)與1項群集式的隨機對照試驗(6種衛生設施)符合了收集的標準。這些試驗在方法方面的品質都不盡理想,而且沒有任何1項曾經適當地評估治療失敗的情形。在所有的試驗當中,單位劑量包裝型藥物(連同開立處方者的訓練與病患的資訊)看起來會使得參與者報告所提到的治療依從行為變得比較高。有1份來自2項試驗(596名參與者)的統合分析顯示,跟裝在紙製信封袋當中的錠劑(RR 1.18,1.12到1.25)比較起來,使用吸塑包裝型的錠劑可以使得參與者報告所提到的治療依從行為變得比較高。有2項試驗使用了裝在分段式之聚乙烯袋當中的錠劑來當作介入行為,也發現到參與者報告所提到的治療依從行為升高了:這份群集式的隨機對照試驗(6個群集)將它與裝在紙製信封袋當中的錠劑進行了比較,至於其他的試驗則將它與裝在瓶子裡面的糖漿進行了比較(RR 2.15,1.76到2.61;299名參與者)。




此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。