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Artemisinin compounds clear parasitaemia more rapidly than other drugs do in both mild and severe malaria, but no advantage in clinical efficacy has been shown. We have compared artemether treatment with standard quinine treatment in Malawian children with cerebral malaria. 65 unconscious children were randomly allocated to intravenous quinine (n = 37) or intramuscular artemether (n = 28) treatment. The two groups were well matched for various prognostic features. Median parasite clearance times were shorter in the artemether group (28 [interquartile range 18-34] vs 40 [36-44] h in the quinine group, p = 0.0002). Coma resolution times were also shorter with artemether than with quinine (8 [4-15] vs 14 [10-36] h, p = 0.01).

Original publication

DOI

10.1016/0140-6736(93)90423-e

Type

Journal article

Journal

Lancet

Publication Date

13/03/1993

Volume

341

Pages

661 - 662

Keywords

Africa, Africa South Of The Sahara, Age Factors, Biology, Central Nervous System, Central Nervous System Effects, Cerebrovascular Effects, Child, Child Mortality, Delivery Of Health Care, Demographic Factors, Developing Countries, Diseases, Drugs, Eastern Africa, English Speaking Africa, Health, Health Services, Malaria, Malawi, Medicine, Mortality, Neurologic Effects, Parasitic Diseases, Physiology, Plants, Medicinal, Population, Population Characteristics, Population Dynamics, Research Report, Signs And Symptoms, Treatment, Youth, Animals, Antimalarials, Artemether, Artemisinins, Child, Preschool, Coma, Female, Humans, Infant, Malaria, Cerebral, Malawi, Male, Plasmodium falciparum, Proportional Hazards Models, Quinine, Sesquiterpenes, Time Factors, Treatment Outcome