Comparison of artemether and chloroquine for severe malaria in Gambian children.

Artemether is an oil-soluble methyl ether of artemesinin (qinghaosu). It has been studied extensively in China, where it has been shown to be rapidly effective in severe falciparum malaria. Nearly all the patients studied previously were adults. We have investigated the efficacy of artemether in chi...

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Main Authors: White, N, Waller, D, Crawley, J, Nosten, F, Chapman, D, Brewster, D, Greenwood, B
Format: Journal article
Sprog:English
Udgivet: 1992
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author White, N
Waller, D
Crawley, J
Nosten, F
Chapman, D
Brewster, D
Greenwood, B
author_facet White, N
Waller, D
Crawley, J
Nosten, F
Chapman, D
Brewster, D
Greenwood, B
author_sort White, N
collection OXFORD
description Artemether is an oil-soluble methyl ether of artemesinin (qinghaosu). It has been studied extensively in China, where it has been shown to be rapidly effective in severe falciparum malaria. Nearly all the patients studied previously were adults. We have investigated the efficacy of artemether in children with moderate or severe falciparum malaria. In the preliminary study of moderately severe malaria, 30 Gambian children were randomised in pairs to receive either intramuscular artemether (4 mg/kg loading dose followed by 2 mg/kg daily) or intramuscular chloroquine ('Nivaquine') 3.5 mg base/kg every 6 h. Both drugs were well tolerated and rapidly effective. The times to parasite clearance were significantly shorter in the artemether recipients (mean 36.7 [SD 11.3] vs 48.4 [16.8] h, p less than 0.05). 43 children with severe malaria were then randomised to receive intramuscular treatment with the same regimens of artemether (n = 21) or chloroquine (n = 22) as used in the preliminary study. 8 children (19%) died. There were no significant differences between the two groups in the clinical, haematological, biochemical, or parasitological measures of therapeutic response in survivors and there was no evidence of local or systemic toxicity. Despite similar parasite counts on admission, clearance times overall were longer in severe malaria than in moderate malaria. Artemether is a well tolerated and rapidly effective parenteral treatment for severe malaria in children, and would be especially valuable in areas with chloroquine-resistant P falciparum.
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spelling oxford-uuid:06e9a3a2-b7f4-43a8-92ba-e5d72eae85b52022-03-26T09:04:52ZComparison of artemether and chloroquine for severe malaria in Gambian children.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:06e9a3a2-b7f4-43a8-92ba-e5d72eae85b5EnglishSymplectic Elements at Oxford1992White, NWaller, DCrawley, JNosten, FChapman, DBrewster, DGreenwood, BArtemether is an oil-soluble methyl ether of artemesinin (qinghaosu). It has been studied extensively in China, where it has been shown to be rapidly effective in severe falciparum malaria. Nearly all the patients studied previously were adults. We have investigated the efficacy of artemether in children with moderate or severe falciparum malaria. In the preliminary study of moderately severe malaria, 30 Gambian children were randomised in pairs to receive either intramuscular artemether (4 mg/kg loading dose followed by 2 mg/kg daily) or intramuscular chloroquine ('Nivaquine') 3.5 mg base/kg every 6 h. Both drugs were well tolerated and rapidly effective. The times to parasite clearance were significantly shorter in the artemether recipients (mean 36.7 [SD 11.3] vs 48.4 [16.8] h, p less than 0.05). 43 children with severe malaria were then randomised to receive intramuscular treatment with the same regimens of artemether (n = 21) or chloroquine (n = 22) as used in the preliminary study. 8 children (19%) died. There were no significant differences between the two groups in the clinical, haematological, biochemical, or parasitological measures of therapeutic response in survivors and there was no evidence of local or systemic toxicity. Despite similar parasite counts on admission, clearance times overall were longer in severe malaria than in moderate malaria. Artemether is a well tolerated and rapidly effective parenteral treatment for severe malaria in children, and would be especially valuable in areas with chloroquine-resistant P falciparum.
spellingShingle White, N
Waller, D
Crawley, J
Nosten, F
Chapman, D
Brewster, D
Greenwood, B
Comparison of artemether and chloroquine for severe malaria in Gambian children.
title Comparison of artemether and chloroquine for severe malaria in Gambian children.
title_full Comparison of artemether and chloroquine for severe malaria in Gambian children.
title_fullStr Comparison of artemether and chloroquine for severe malaria in Gambian children.
title_full_unstemmed Comparison of artemether and chloroquine for severe malaria in Gambian children.
title_short Comparison of artemether and chloroquine for severe malaria in Gambian children.
title_sort comparison of artemether and chloroquine for severe malaria in gambian children
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AT chapmand comparisonofartemetherandchloroquineforseveremalariaingambianchildren
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