Intrarectal quinine for treating Plasmodium falciparum malaria

Eisenhut, Michael; Omari, Aika Aa

doi:10.1002/14651858.cd004009.pub2

Cited by 9 publications

(4 citation statements)

References 20 publications

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“…These findings are particularly important, because there are limited data on the efficacy of intrarectal quinine for treatment of life-threatening forms of malaria. This study addresses a need for more trials, as recommended by Eisenhut et al [16].…”

Section: Discussionmentioning

confidence: 95%

Rectal versus Intravenous Quinine for the Treatment of Childhood Cerebral Malaria in Kampala, Uganda: A Randomized, Double-Blind Clinical Trial

Achan¹,

Byarugaba²,

Hubert³

et al. 2007

Clinical Infectious Diseases

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Background. Although artemesinin derivatives are promising for the treatment of severe Plasmodium falciparum malaria, intravenous quinine remains the most affordable treatment. However, administration of intravenous quinine is often not feasible in rural areas in Africa because of the lack of simple equipment or trained staff. We compared the efficacy and safety of intrarectal quinine with those of intravenous quinine in the treatment of childhood cerebral malaria.Methods. In a randomized, double-blind clinical trial at Mulago Hospital (Kampala, Uganda), Uganda's national referral hospital, we studied 110 children aged 6 months to 5 years who had cerebral malaria. Patients were randomized to receive either intrarectal or intravenous quinine. Main outcome measures included parasite clearance time, fever clearance time, coma recovery time, time to sit unsupported, time to begin oral intake, time until oral quinine was tolerated, and death.Results. Overall, there was no difference in the clinical and parasitological outcomes between the 2 groups (data are deviation, intrarectal quinine group vs. intravenous quinine group): coma recovery time, h versus mean ‫ע‬ standard 19.4 ‫ע‬ 18.1 h; fever clearance time, h versus h; and parasite clearance time, h versus 17.0 ‫ע‬ 12.1 26.7 ‫ע‬ 16.1 29.9 ‫ע‬ 18.1 43.2 ‫ע‬ 14.2 h. Mortality was similar in both groups; 4 of 56 patients in the intrarectal quinine group died, and 5 of 54 patients 41.9 ‫ע‬ 15.2 in the intravenous quinine group died (odds ratio, 1.3; 95% confidence interval, 0.3-5.2). Intrarectal quinine was well tolerated, and no major immediate adverse events occurred.Conclusions. Intrarectal quinine is efficacious and could be used as an alternative in the treatment of childhood cerebral malaria, especially in situations in which intravenous therapy is not feasible.

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Section: Discussionmentioning

confidence: 95%

Rectal versus Intravenous Quinine for the Treatment of Childhood Cerebral Malaria in Kampala, Uganda: A Randomized, Double-Blind Clinical Trial

Achan¹,

Byarugaba²,

Hubert³

et al. 2007

Clinical Infectious Diseases

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“…A quarter of patients had liquid stools after first administration and when they reached the referral care centre the proportion increased to three quarters. In previous trials much lower proportion of liquid stools were reported [15,16]. Such difference can be explained by the differences in disease severity and clinical presentation at inclusion.…”

Section: Discussionmentioning

confidence: 91%

Acceptability and efficacy of intra-rectal quinine alkaloids as a pre-transfer treatment of non-per os malaria in peripheral health care facilities in Mopti, Mali

Thera

Keita

Sissoko

et al. 2007

Malar J

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“…Provision of a wall chart indicating health education topics to be covered could also be an option to supplement the training. Several randomized trials indicate the clinical efficacy of rectal artesunate and rectal quinine is superior to the intravenous quinine in treatment of severe malaria [8][9][10]. Obviously, dosage routes other than the intravenous require less calculation skills and they might be considered as an alternative solution.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Performance of Nurses in the Management of Malaria Patients in Tanzania

Kanamori¹,

Kohi

Nyamhanga

et al. 2010

Journal of Tropical Pediatrics

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The nurses do not satisfy the required standard in the management of malaria patients. The weak areas identified by the study are the quinine IV administration and health education provided to patients. Conducting a training programme for nurses and the provision of working aids, such as a dosage table and a wall chart, are recommended. Furthermore, in order to alleviate incorrect dosage in intravenous quinine administration associated with dosage calculation, the possibility of adopting treatment drugs that can be administered by other dosage routes could be explored.

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Intrarectal quinine for treating Plasmodium falciparum malaria

Cited by 9 publications

References 20 publications

Rectal versus Intravenous Quinine for the Treatment of Childhood Cerebral Malaria in Kampala, Uganda: A Randomized, Double-Blind Clinical Trial

Rectal versus Intravenous Quinine for the Treatment of Childhood Cerebral Malaria in Kampala, Uganda: A Randomized, Double-Blind Clinical Trial

Acceptability and efficacy of intra-rectal quinine alkaloids as a pre-transfer treatment of non-per os malaria in peripheral health care facilities in Mopti, Mali

Assessing the Performance of Nurses in the Management of Malaria Patients in Tanzania

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