Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial
Abstract Background Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous m...
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ftdoajarticles:oai:doaj.org/article:6bef68017a5a486d9d12e5cf3c7430c2 2023-05-15T15:13:23+02:00 Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial Byarugaba Justus S Ndeezi Grace Namutangula Beatrice Tumwine James K 2007-10-01T00:00:00Z https://doi.org/10.1186/1475-2875-6-138 https://doaj.org/article/6bef68017a5a486d9d12e5cf3c7430c2 EN eng BMC http://www.malariajournal.com/content/6/1/138 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-6-138 1475-2875 https://doaj.org/article/6bef68017a5a486d9d12e5cf3c7430c2 Malaria Journal, Vol 6, Iss 1, p 138 (2007) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2007 ftdoajarticles https://doi.org/10.1186/1475-2875-6-138 2022-12-30T22:52:09Z Abstract Background Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria. Methods This randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects. Results Time to regain consciousness (p = 0.11), sit unsupported (p = 0.81), time to start oral intake (p = 0.13) and total coma duration (p = 0.07) were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3%) and mannitol (10/76 or 13.2%) groups: RR = 1.2 (CI 0.5–2.7). No adverse effects were observed after administration of mannitol. Conclusion Mannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria. Clinical registration number ClinicalTrials.gov ID: NCT00113854 Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 6 1 138 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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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 Byarugaba Justus S Ndeezi Grace Namutangula Beatrice Tumwine James K Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria. Methods This randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects. Results Time to regain consciousness (p = 0.11), sit unsupported (p = 0.81), time to start oral intake (p = 0.13) and total coma duration (p = 0.07) were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3%) and mannitol (10/76 or 13.2%) groups: RR = 1.2 (CI 0.5–2.7). No adverse effects were observed after administration of mannitol. Conclusion Mannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria. Clinical registration number ClinicalTrials.gov ID: NCT00113854 |
format |
Article in Journal/Newspaper |
author |
Byarugaba Justus S Ndeezi Grace Namutangula Beatrice Tumwine James K |
author_facet |
Byarugaba Justus S Ndeezi Grace Namutangula Beatrice Tumwine James K |
author_sort |
Byarugaba Justus S |
title |
Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_short |
Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_full |
Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_fullStr |
Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_full_unstemmed |
Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_sort |
mannitol as adjunct therapy for childhood cerebral malaria in uganda: a randomized clinical trial |
publisher |
BMC |
publishDate |
2007 |
url |
https://doi.org/10.1186/1475-2875-6-138 https://doaj.org/article/6bef68017a5a486d9d12e5cf3c7430c2 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 6, Iss 1, p 138 (2007) |
op_relation |
http://www.malariajournal.com/content/6/1/138 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-6-138 1475-2875 https://doaj.org/article/6bef68017a5a486d9d12e5cf3c7430c2 |
op_doi |
https://doi.org/10.1186/1475-2875-6-138 |
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Malaria Journal |
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6 |
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1 |
container_start_page |
138 |
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