Skip to main content

Advertisement

Table 2 Summary of studies of quinine for the treatment of severe 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 Treatment outcome Comment Reference
Gambia 1992-1994 576 children 1-9 years Cerebral malaria Intramuscular artemether (IMA) Intravenous quinine (IVQ) Mortality: IMA:20.5% IVQ: 21.5% Neurological sequelae: IMA: 3.3% IVQ: 5.3% Artemether is as effective as quinine in treatment of cerebral malaria in children [74]
Malawi 1992-1994 183 children Cerebral malaria Intramuscular artemether (IMA) Intravenous quinine (IVQ) Mortality: IMA: 11% IVQ: 16% Survival with neurological sequelae: IMA: 19% IVQ: 12% Results do not suggest artemether would confer a survival advantage over quinine [73]
Kenya 2000-2002 360 patients 1-60 years Severe malaria IV Quinine + oral malarone (QM) IV Quinine +oral quinine (QQ) Day 28 cure rates: QM: 98.7% QQ: 90% Using malarone after IV quinine is safer and as effective as IV quinine +oral quinine [87]
Burkina Faso 2001-2002 898 children 1-15 years Moderately severe malaria Rectal quinine (RQ) Intramuscular quinine (IMQ) Early treatment failure (day 3): RQ: 6% IMQ: 3% Fever recurrence on day 7: RQ: 5% IMQ: 10% Rectal quinine had acceptable safety profile and could be used as early treatment for severe malaria [84]
Uganda 2002-2003 103 children 0.5-5 years Cerebral malaria Rectal artemether (RA) Intravenous quinine (IVQ) Mortality: IVQ: 11.7% RA: 19.2% Rectal artemether was effective and well tolerated [76]
S.E Asia (Four countries) 2003-2005 1461 patients >2 years Severe malaria Intravenous artesunate (IVA) Intravenous quinine (IVQ) Mortality: IVA: 15% IVQ: 22% Absolute reduction in mortality: 34.7% Intravenous artesunate should be treatment of choice for severe malaria in adults [20]
Uganda 2003-2004 110 children 0.5-5 years Cerebral malaria Rectal quinine (RQ) Intravenous quinine (IVQ) Mortality: RQ: 7% IVQ: 9% Comparable clinical and parasitological outcomes Rectal quinine was efficacious and could be used as a treatment alternative [79]
Africa (Nine countries) 2005-2010 5425 children < 15 years Severe malaria Intravenous artesunate (IVA) Intravenous quinine (IVQ) Mortality: IVA: 8.5% IVQ: 10.9% Relative reduction in mortality: 22.5% Parenteral artesunate should replace quinine as the treatment of choice for severe malaria [21]