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Seventy-nine comatose cerebral malaria patients given standard supportive treatment were randomized to receive specific antimalarial chemotherapy of intravenous quinine, intravenous artesunate, or artemisinin suppositories. Artesunate and artemisinin reduced peripheral asexual parasitaemia significantly more rapidly than quinine (90% clearance time 16 h, 18.9 h and 34.5 h respectively), but did not significantly reduce the duration of coma or mortality. The rapid lowering of peripheral parasitaemia may not ameliorate complications already present. These results demonstrate that artemisinin suppositories are as effective as artesunate and quinine given intravenously, and have economic and practical advantages for the treatment of severe malaria in areas remote from major medical centres. However, large numbers of patients will need to be studied if differences in mortality between the 3 treatment groups are to be demonstrated.

Original publication

DOI

10.1016/0035-9203(92)90137-2

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

11/1992

Volume

86

Pages

582 - 583

Keywords

Adolescent, Adult, Animals, Antimalarials, Artemisinins, Artesunate, Female, Humans, Injections, Intravenous, Malaria, Cerebral, Male, Middle Aged, Plasmodium falciparum, Quinine, Sesquiterpenes, Suppositories