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Table 1 Summary of studies of quinine for the treatment of uncomplicated malaria

From: Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria

Study site Year Sample size and study population Drug Regimens Duration of follow-up Treatment outcome Comment Reference
Thailand, region with multidrug resistant malaria 1984-1985 66 children
2-12 years
Quinine Quinidine 28 days
DOT
Cure rates:
Quinine - 85%
Quinidine - 88%
Treatment failures only RI responses [29]
Cambodia, region with multidrug resistant malaria 1983 119 adults,
>15 years
Mefloquine +SP (MSP)
3 days quinine+tetracycline (Q3T7)
7 days of quinine+ tetracycline (Q7T7)
28 days
DOT
Cure rates:
MSP: 98%
Q3T7: 76%
Q7T7: 92%
Q7T7 still gives good cure rate [30]
Brazil, setting with quinine resistance 1985 100 patients
18-55 years
Mefloquine 1000 mg single dose (MQ)
3 days quinine+SP (Q3+SP)
42 days
DOT
Cure rates:
MQ:
96%
Q3 + SP: 98%
Four RI responses in Q3 + SP group [31]
Thailand, region with multidrug resistant malaria 1994 102 patients
16-60 years
Mefloquine+tetracycline (MQT)
7 days of Quinine+ tetracycline (Q7T7)
28 days
DOT
Cure rates:
MQT: 94%
Q7T7: 98%
MQ + Tetra as effective as Q7T7 [34]
Thailand, region with multidrug resistant malaria 1995-1997 204 male patients
15-64 years
7 days quinine (Q7)
Quinine + tetracycline (Q7T7)
Quinine + clindamycin (Q7C7)
28 days
Directly observed therapy
Cure rates:
Q7: 87%
Q7T7: 98%
Q7C7: 100%
Tetracycline or clindamycin improves quinine cure rates [33]
Equatorial Guinea, setting with no quinine resistance 1999 114 children
6-59 months
7days quinine (Q7)
Chloroquine (CQ)
Sulfadoxine/pyrimethamine (SP)
114 day follow-up Cure rates:
Q7: 94.5%
CQ: 60%
SP: 90%
Quinine is effective against P.falciparum malaria [43]
Cameroon, High transmission setting 2005 30 children
0.5-6 years
5 days quinine (Q5) 14 day follow-up Cure rates: 100%   [41]
Burundi Perennial transmission setting 1992-1995 472 children
0-14 years
Chloroquine (CQ)
5 days quinine (Q5)
7 day follow-up Failure rates Q5:
1992-1993: 4.2%
1994-1995: 7.1%
  [40]
Guinea-Bissau Perennial transmission setting 1994-1995 203 children
0.7-13 years
3 days quinine (Q3)
5 days quinine (Q5)
7 days quinine (Q7)
28-35 day follow-up Day 28 recurrent parasitemia:
Q3: 79%
Q5: 90%
Q7: 11%
3 day quinine regimens should not be used. [37]
Gabon High transmission setting 1993-1994 120 adults = 15years 3 days quinine (Q3)
3 days quinine+clindamycin (Q3C3)
3 days quinine+doxycycline (Q3D3)
28 day follow-up Day 28 cure rates:
Q3: 38%
Q3C3: 92%
Q3D3: 91%
The two short course combinations of quinine had excellent cure rates [109]
Uganda Meso-endemic transmission setting 2007-2008 175 children
6months - 5 years
7 days quinine (Q7)
3 days artemether-lumefantrine (AL)
28 day follow-up Cure rates:
Q7: 64%
AL: 97%
Results question the advisability of quinine use for uncomplicated malaria [45]