Comparison of intramuscular artemether and intravenous quinine in the treatment of Sudanese children with severe falciparaum malaria

Adam, Ishag; Idris, H M; Mohamedali, Alaa; Aelbasit, I A; Elbashir, Mustafa I.

doi:10.4314/eamj.v79i12.8668

Cited by 26 publications

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“…Interestingly, >70% of the new parasitaemias detected during the follow-up period of the present study were found to be true recrudescences, confirming the existence of quinine resistance in the New Halfa area (Adam et al, 2001(Adam et al, , 2002. If all the new parasitaemias had been assumed to be re-infections, the apparent efficacy of the quinine treatment would have been greater.…”

Section: Discussionsupporting

confidence: 87%

Low-dose quinine is effective in the treatment of chloroquine-resistantPlasmodium falciparummalaria in eastern Sudan

Ibrahim

Elbashir

Naser

et al. 2004

Annals of Tropical Medicine & Parasitology

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In November-December 2002, 98 patients presented at the Elhara Eloula health centre, in the New Halfa area of eastern Sudan, with Plasmodium falciparum malaria that had failed to respond to chloroquine treatment. After informed consent was obtained, 93 of these patients were randomly allocated to one of three regimens for quinine treatment, being given the drug, orally and sometimes intravenously, for 7 days, at doses of 10 mg/kg thrice daily (32 patients), 10 mg/kg twice daily (31 patients) or 15 mg/kg once daily (30 patients). All the patients were followed daily until day 7 and then weekly until day 28. There was no significant difference in the parasite-clearance times observed in the three groups. Parasitaemias re-occurred by day 28 in 12 patients: two (6.3%) of the patients treated thrice daily, five (16.1%) of those treated twice daily, and five (16.7%) of those treated once daily (P > 0.05). Genotyping indicated that in nine of these 12 patients the parasitaemias that developed post-treatment represented true recrudescences and not re-infections. In the treatment of chloroquine-resistant, P. falciparum malaria in Sudan, once-daily treatment with quinine, in a relatively low daily dose (15 mg/kg. day), appears as effective as the thrice-daily treatment (at 30 mg/kg. day) often recommended.

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Section: Discussionsupporting

confidence: 87%

Low-dose quinine is effective in the treatment of chloroquine-resistantPlasmodium falciparummalaria in eastern Sudan

Ibrahim

Elbashir

Naser

et al. 2004

Annals of Tropical Medicine & Parasitology

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“…We have previously observed the same manifestations of severity that were due to P. falciparum malaria in the same pediatric ward as well as in the different regions of Sudan [14-17]. Only 3% of malaria cases (99/1539 blood films from 190 individuals) in the same setting were P. vivax while 95% were P. falciparum malaria giving the rate of P. vivax/P.…”

Section: Discussionmentioning

confidence: 67%

“…The vast majority of these reports on severe P. vivax malaria are from south East Asia and India, there are few published data on severe P. vivax from Africa [13]. The current study was conducted at New Halfa hospital in the eastern Sudan during the period of September 2009 - December 2011 to investigate manifestations of severe P. vivax among children so as to add to the previous studies on severe malaria and its treatment in Sudan [14-17]. Such data is of paramount importance for the care givers, health planners and for controlling the disease e.g.…”

Section: Introductionmentioning

confidence: 99%

Severe Plasmodium vivax malaria among sudanese children at New Halfa Hospital, Eastern Sudan

Mahgoub¹,

Gasim

Musa

et al. 2012

Parasites Vectors

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BackgroundThere are few published reports on severe Plasmodium vivax malaria in Africa.MethodsClinical pattern/manifestations of severe P. vivax were described in children admitted at New Halfa Hospital in Sudan between September 2009-December 2011.ResultsEighteen children were admitted at the hospital during the study period with different manifestations of severe P. vivax malaria namely: severe anaemia (6, 33.3%), jaundice (5, 27.8%), thrombocytopenia (4, 22.2%), hypotension (3, 16.7%), cerebral malaria (2, 11.1%), epistaxis (2, 11.1%), renal impairment (1, 5.5%), hypogylcaemia and more than one manifestation (5, 27.8%).By day 2, all patients were asymptomatic, a parasitaemic and had started oral quinine and primaquine. There was no death among these patientsConclusionSevere P. vivax malaria is an existing entity in eastern Sudan. Further studies are required to understand emergence of severe P. vivax malaria.

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“…Perhaps that study failed to show a difference in the fever and parasite clearance time because it was a small-scale study involving only children, while in the current study, both children and adults were enrolled. Likewise, it has been observed previously that fever clearance time and parasite clearance time (16.0 and 22.4 hours, respectively) were shorter when intramuscular artemether was compared with quinine in the treatment of Sudanese children with severe P. falciparum malaria in eastern Sudan [10]. The mean parasite clearance time shown in this study was relatively shorter than the results (68 hours) obtained from other studies in Southeast Asia [14] and a parasite clearance time of 29.5 hours that was reported among non-immunized European travelers [15].…”

Section: Discussionmentioning

confidence: 96%

“…Such a study will generate data that is of paramount importance for both health planners and caregivers. Thus, the aim of the current study was to compare the efficacy of intravenous artesunate with that of quinine in the treatment of severe P. falciparum malaria in eastern Sudan to add to the research on the treatment of severe malaria in Sudan [9,10].…”

Section: Introductionmentioning

confidence: 99%

Comparison of artesunate and quinine in the treatment of severe Plasmodium falciparum malaria at Kassala hospital, Sudan

Abdallah

Elmardi²,

Elhassan³

et al. 2014

J Infect Dev Ctries

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Introduction: There is a need to investigate the treatment (artesunate and quinine) of severe malaria, as this will influence the outcome of morbidity and the mortality of the disease.Methodology: An open randomized trial conducted at Kassala, Sudan. Patients with severe P. falciparum malaria were randomly assigned to either intravenous artesunate at 2.4 mg/kg at 0, 12, and 24 hours, then daily, or intravenous quinine at a 20 mg/kg loading dose, then 10 mg/kg three times a day. Fever and parasite clearance and coma resolution time were compared between the two groups . Results: The two groups (47 in each group) were well matched in the clinical and biochemical characteristics. Hypotension, convulsions, severe anemia, hypoglycemia, cerebral malaria, and jaundice were the predominant manifestations of severe malaria. The mean (SD) of the fever clearance (10.8 [5.5] vs. 14.0 [8.1] hours, p = 0.028) and the parasite clearance time (16.5 [6.4] vs. 21.7 [11.3] hours, p = 0.007) were significantly shorter in the artesunate-treated patients. In comatose patients, there was no difference between the two groups in coma resolution time. Following quinine infusion, ten patients developed tinnitus (p < 0.001), and four had hypoglycemia (p = 0.033). Tinnitus and hypoglycemia were not detected in the artesunate group. One patient in the artesunate group died. Conclusions: Artesunate is more effective than quinine, in term of parasite and fever clearance time, in the treatment of P. falciparum malaria in eastern Sudan. The study found no difference between artesunate and quinine in coma resolution time.

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Comparison of intramuscular artemether and intravenous quinine in the treatment of Sudanese children with severe falciparaum malaria

Cited by 26 publications

References 0 publications

Low-dose quinine is effective in the treatment of chloroquine-resistantPlasmodium falciparummalaria in eastern Sudan

Low-dose quinine is effective in the treatment of chloroquine-resistantPlasmodium falciparummalaria in eastern Sudan

Severe Plasmodium vivax malaria among sudanese children at New Halfa Hospital, Eastern Sudan

Comparison of artesunate and quinine in the treatment of severe Plasmodium falciparum malaria at Kassala hospital, Sudan

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