Comparative study of artemether and quinine in severe Plasmodium falciparum malaria in adults and older children in Cameroon

• Published in: Médecine tropicale Vol. 59; no. 2; p. 151
• Main Authors: Fargier, J J, Louis, F J, Duparc, S, Hounsinou, C, Ringwald, P, Danis, M
• Format: Magazine Article
• Language: French
• Published: France 1999
• Subjects: Adolescent; Adult; Antimalarials - therapeutic use; Artemisinins; Cameroon; Child; Coma - diagnosis; Coma - parasitology; Fever - parasitology; Glasgow Coma Scale; Humans; Infusions, Intravenous; Injections, Intramuscular; Malaria, Falciparum - blood; Malaria, Falciparum - complications; Malaria, Falciparum - drug therapy; Malaria, Falciparum - parasitology; Middle Aged; Prospective Studies; Quinine - therapeutic use; Sesquiterpenes - therapeutic use; Severity of Illness Index; Cameroon
• ISSN: 0025-682X

From June 1993 to June 1994, a study was carried out to compare artemether and quinine for management of severe falciparum malaria in adults and adolescents in Cameroon. Artemether was administered intramuscularly at a dose of 3.6 mg/kg on the first day and 1.6 mg/kg for the following 4 days. Quinine was administered intravenously at a dose of 1.6 mg/kg for the first 4 hours and 8 mg every 8 hours for the next 3 days. The files of 84 of the 95 patients recruited were validated for inclusion in the final study. There were 40 patients in the artemether group and 44 in the quinine group. The two groups were comparable with regard to all factors at the time of inclusion. Findings showed that artemether was more effective than quinine with regard to total clearance of parasitemia, 90 p. 100 clearance, and fever control and that it was as effective with regard to 50 p. 100 clearance and recovery of consciousness. In view of its good performance and of the simplicity of its administration by intramuscular injection, artemether would appear to be an excellent alternative for treatment of severe malaria and cerebral malaria in areas with poor medical facilities.