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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 --
  1. agr refers to grains of quinine. One grain = 64.8 mg quinine; IM: intra-muscular; IV: Intravenous.
  2. bThe modern treatment regimen is 20 mg/kg loading dose, and then 10 mg/kg x 3 daily x 7 days. This total loading dose in grains for a 75 kg man, equates to 23.1 grains. The maintenance dose equates to 11.6 grains x 3 daily.
  3. cNeeds further investigation.
  4. dGerman studies use dose suffix of g (not gr).
  5. eDetails may have been censored.