Skip Navigation


Journal of Tropical Pediatrics Advance Access originally published online on December 15, 2004
Journal of Tropical Pediatrics 2005 51(1):17-24; doi:10.1093/tropej/fmh069
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
51/1/17    most recent
fmh069v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Esamai, F.
Right arrow Articles by Jakait, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Esamai, F.
Right arrow Articles by Jakait, B.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Journal of Tropical Pediatrics, Vol. 51, No. 1 © Oxford University Press 2005; all rights reserved

A Randomized Open Label Clinical Trial to Compare the Efficacy and Safety of Intravenous Quinine Followed by Oral Malarone vs. Intravenous Quinine Followed by Oral Quinine in the Treatment of Severe Malaria

F. Esamai1 *, C. N. Tenge1, P. O. Ayuo2, W. Owino Ong'or2, A. Obala3 and B. Jakait4

1 Department of Child Health and Paediatrics, Faculty of Health Sciences, Moi University, Kenya, 2 Department of Medicine, Faculty of Health Sciences, Moi University, Kenya, 3 Department of Microbiology and Parasitology, Faculty of Health Sciences, Moi University, Kenya, 4 Moi Teaching and Referral Hospital, Eldoret, Kenya

The treatment of patients with severe malaria in sub-Saharan Africa has become a challenge to clinicians due to poor compliance to quinine and the increasing multidrug resistance to antimalarials by the P. falciparum parasite. The aim of this study was to compare the efficacy and safety profile of two truncated antimalarial regimens of intravenous quinine followed by oral Malarone (Malarone arm) with intravenous quinine followed by oral quinine (quinine arm) in the treatment of severe P. falciparum malaria. The outcome measures were parasite clearance time, fever clearance time, efficacy, and adverse events profile. Consecutive patients aged 1–60 years, with a diagnosis of severe malaria with positive blood smears for P. falciparum parasites and admitted to the Moi Teaching and Referral Hospital were randomized into the two study arms. Of the 360 patients studied 167 and 193 cases were randomized into the Malarone and quinine arms, respectively. Of the five (1.4 per cent) patients who died, three came from the quinine arm. The frequency of adverse reactions was higher in the oral quinine group (31.6 per cent) than in the Malarone group (25.7 per cent). The mean parasite clearance time was 120 h and 108 h for the quinine and Malarone arms of the study, respectively, and the mean fever clearance times were 84 h and 72 h for the quinine and Malarone arms, respectively (p = 0.1). Truncated therapeutic regimen using malarone after intravenous quinine is safer and as effective as conventional intravenous quinine followed by oral quinine in the treatment of severe malaria. The P. falciparum recrudescence rate was lower with the use of Malarone than for quinine.

* Correspondence: Prof. F. Esamai, Department of Child Health and Paediatrics, Faculty of Health Sciences, Moi University, P.O. Box 4606, Eldoret, Kenya. E-mail <fesamai{at}africaonline.co.ke>.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Proc. Natl. Acad. Sci. USAHome page
C. Beeton, H. Wulff, N. E. Standifer, P. Azam, K. M. Mullen, M. W. Pennington, A. Kolski-Andreaco, E. Wei, A. Grino, D. R. Counts, et al.
Kv1.3 channels are a therapeutic target for T cell-mediated autoimmune diseases
PNAS, November 14, 2006; 103(46): 17414 - 17419.
[Abstract] [Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.