A Cochrane review [Abstract] 1 included 4 trials with a total of 144 subjects. Loading dose was associated with fewer deaths, but this was not statistically significant (RR 0.62, 95% CI 0.19 to 2.04, 3 trials). Loading dose was associated with faster clearance of parasites (WMD -7.44 hours, 95% CI -13.24 to -1.64 hours, 2 trials) and resolution of fever (WMD -11.11 hours, 95% CI -20.04 to -2.18 hours, 2 trials). No statistically significant difference was detected for recovery of consciousness, neurological sequelae, or convulsions, but the numbers were small.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding).
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