Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review
Abstract Background The efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria...
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ftdoajarticles:oai:doaj.org/article:1b915ecd782a47c8ae51a49759960e3c 2023-05-15T15:14:05+02:00 Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review de Frey Albie PrayGod George Eisenhut Michael 2008-10-01T00:00:00Z https://doi.org/10.1186/1475-2875-7-210 https://doaj.org/article/1b915ecd782a47c8ae51a49759960e3c EN eng BMC http://www.malariajournal.com/content/7/1/210 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-210 1475-2875 https://doaj.org/article/1b915ecd782a47c8ae51a49759960e3c Malaria Journal, Vol 7, Iss 1, p 210 (2008) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2008 ftdoajarticles https://doi.org/10.1186/1475-2875-7-210 2022-12-31T00:10:12Z Abstract Background The efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria in children is not clearly understood. The objective of this review was to assess the efficacy of parenteral artemisinin derivatives versus parenteral quinine in treating severe malaria in children. Methods All randomized controlled studies comparing parenteral artemisinin derivatives with parenteral quinine in treating severe malaria in children were included in the review. Data bases searched were: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007), MEDLINE (1966 to February 2008), EMBASE (1980 to February 2008), and LILACS (1982 to February 2008). Dichotomous variables were compared using risk ratios (RR) and the continuous data using weighted mean difference (WMD). Results Twelve trials were included (1,524 subjects). There was no difference in mortality between artemisinin derivatives and quinine (RR = 0.90, 95% CI 0.73 to 1.12). The artemisinin derivatives resolved coma faster than quinine (WMD = -4.61, 95% CI: -7.21 to -2.00, fixed effect model), but when trials with adequate concealment only were considered this differences disappeared. There was no statistically significant difference between the two groups in parasite clearance time, fever clearance time, incidence of neurological sequelae and 28 th day cure rate. One trial reported significantly more local reactions at the injection site with intramuscular quinine compared to artemether. None of the trials was adequately powered to demonstrate equivalence. Conclusion There was no evidence that treatment of children with severe malaria with parenteral artemisinin derivatives was associated with lower mortality or long-term morbidity compared to parenteral quinine. Future studies require adequately powered equivalence ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 7 1 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 de Frey Albie PrayGod George Eisenhut Michael Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria in children is not clearly understood. The objective of this review was to assess the efficacy of parenteral artemisinin derivatives versus parenteral quinine in treating severe malaria in children. Methods All randomized controlled studies comparing parenteral artemisinin derivatives with parenteral quinine in treating severe malaria in children were included in the review. Data bases searched were: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007), MEDLINE (1966 to February 2008), EMBASE (1980 to February 2008), and LILACS (1982 to February 2008). Dichotomous variables were compared using risk ratios (RR) and the continuous data using weighted mean difference (WMD). Results Twelve trials were included (1,524 subjects). There was no difference in mortality between artemisinin derivatives and quinine (RR = 0.90, 95% CI 0.73 to 1.12). The artemisinin derivatives resolved coma faster than quinine (WMD = -4.61, 95% CI: -7.21 to -2.00, fixed effect model), but when trials with adequate concealment only were considered this differences disappeared. There was no statistically significant difference between the two groups in parasite clearance time, fever clearance time, incidence of neurological sequelae and 28 th day cure rate. One trial reported significantly more local reactions at the injection site with intramuscular quinine compared to artemether. None of the trials was adequately powered to demonstrate equivalence. Conclusion There was no evidence that treatment of children with severe malaria with parenteral artemisinin derivatives was associated with lower mortality or long-term morbidity compared to parenteral quinine. Future studies require adequately powered equivalence ... |
format |
Article in Journal/Newspaper |
author |
de Frey Albie PrayGod George Eisenhut Michael |
author_facet |
de Frey Albie PrayGod George Eisenhut Michael |
author_sort |
de Frey Albie |
title |
Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
title_short |
Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
title_full |
Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
title_fullStr |
Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
title_full_unstemmed |
Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
title_sort |
artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review |
publisher |
BMC |
publishDate |
2008 |
url |
https://doi.org/10.1186/1475-2875-7-210 https://doaj.org/article/1b915ecd782a47c8ae51a49759960e3c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 7, Iss 1, p 210 (2008) |
op_relation |
http://www.malariajournal.com/content/7/1/210 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-210 1475-2875 https://doaj.org/article/1b915ecd782a47c8ae51a49759960e3c |
op_doi |
https://doi.org/10.1186/1475-2875-7-210 |
container_title |
Malaria Journal |
container_volume |
7 |
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1 |
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1766344577677000704 |