Table 6 British and German military quinine prophylactic and treatment regimens for malaria 1914–1918
From: Malaria’s contribution to World War One – the unexpected adversary
Author or source [reference] | Area and subjects | Year | Prophylactic dose regimena,b | Treatment dose regimen |
|---|---|---|---|---|
British | ||||
Hehir [79] | India | 1914 | All troops quinine treated not < 4 months | -- |
Wenyon [17] | Macedonia | 1916 | 5,10,20,30gr/day tried | 30gr/day x 24 days + arsenic + iron |
1918 | ||||
Editorial BMJ [81] | No restriction | 1916 | Large doses needed | -- |
Laveran [92] | Macedonia | 1917 | 40gr/day (split dose) x 7.5 months | -- |
Treadgold [80] | Macedonia | 1917 | 5-15gr x 2 consecutive days at 1 wk intervals | -- |
Manson [93] | No restriction | 1917 | 5gr/day, or 10gr/x2wk, or 15gr x 10th day | 5gr x 3 days, or 15gr x1 dose x 1 wk; Iron + arsenic for 8wks; then 5gr/day x 3 months x every Spring x 2 years |
Stephens [63] | Liverpool evacuated troops | 1917 | Interrupted courses preferable to continuous. Various doses and scheduling. Arsenic not beneficial, strychnine more beneficial | -- |
Ross [94] | UK special treatment centres | 1917 | 5-60gr/day investigated x 3 wks in various schedules and administration routes. Concluded 60gr/wk reduces relapses to 10% per month | Short and long sterilizing treatments. No difference with administration route |
Regulations UK Govt [95] | UK troops | 1917 | Y scheme: Every soldier to keep 60gr for self-treatment if relapses. Report relapse day or night for blood film and fever check | Y scheme: 15gr/day x 14 days then 60gr/wk x 6 days in optional divided doses |
Paisseau [96] | Balkans | 1917 | 1-2gr/day x 3 days x 1–2 months Iron + arsenic x 1–2 months | IV adrenaline if rigors 2gr preferred if P.falciparum |
1918 | ||||
Anderson [97] | Macedonia | 1917 | 20-45gr both intensive and interrupted x 1–2 months | IV strychnine and adrenaline |
1918 | ||||
Alport [98] | Salonika | 1917 | 1-10gr/day continuous; or 35gr/day x 71 days | Cerebral malaria: 60-100gr in 12 hours x 3 days IM,IV, rectal |
War Govt Medical Services Publication [13] | Conflict zones | 1914 | 10gr x 21 days. Arsenic to reduce anaemia with iron and strychnine (IV if severe). Opium (Warburg’s tincture). Venepuncture to reduce toxaemia (≥1 pint), and replace with normal salinec | Consider blood transfusion twice fortnightly. Splenectomy in severe anaemia |
1918 | ||||
Germand | ||||
Bruns [91] | Macedonia | 1917 | 0.3 -0.6 g/day + arsenic. Recommended 1.5 – 2.0 g/day x 2 weekly x 6–8 wks. Repeat annually for 3 years | -- |
1918 | ||||
Kestner [85] | Macedonia | 1916 | 0.3 -0.9 g/day | -- |
Romania | 1918 | |||
Stendel [99] | Eastern front | 1916 | 0.3 g alternating days x 6 wks | -- |
Abstracts [100] | No restriction | 1918 | Summaries on quinine studies. Various dosese | -- |