Artesunate versus quinine in the treatment of severe falciparum malaria malaria in African children (AQUAMAT): an open-label, randomized trial
This paper describes the results of an open-label randomized trial, comparing the use of artesunate and quinine for the treatment of severe Plasmodium falciparum malaria in children in 11 African countries.
Arjen M Dondorp, Caterina I Fanello, Ilse C E Hendriksen, et al for the AQUAMAT group*, Lancet, 2010;376(9753):1647-57
This paper describes the results of an open-label randomized trial, comparing the use of artesunate and quinine for the treatment of severe Plasmodium falciparum malaria in children in 11 African countries. In the artesunate treatment group, 230 patients (8·5%) died in the hospital, compared with 297 (10·9%) assigned to quinine treatment group, giving an odds ratio stratified for study site of 0·75, with a 95% confidence interval of 0·63–0·90. Treatment with artesunate reduced the mortalityof severe malaria by 22·5%, in comparison with quinine. These results support the use of artesunate treatment as a first choice for the treatment of children with severe Plasmodium falciparum malaria.
ECDC comment: This large study is encouraging for the use of parenteral artesunate for the treatment of severe Plasmodium falciparum malaria cases in European travel medicine.Public Health Significance: The evidence provided by this publication on the efficacy and safety of the use of parenteral artesunate for the treatment of severe Plasmodium falciparum malaria is of great importance regarding the improvement of malaria treatment and mortality.
Severe Plasmodium knowlesi malaria in a tertiary care hospital in Sabah, Malaysian Borneo
56 adult patients with PCR confirmed P. knowlesi malaria from Sabah are described. 22 (39%) of these had strictly defined severe malaria including respiratory distress, acute renal failure and shock.Read more
Expert opinion: Is screening for malaria necessary among asymptomatic refugees and immigrants coming from endemic countries?
This article assesses the findings of a recent Canadian study which measured malaria prevalence among recently arrived asymptomatic refugees.Read more
Artemisinin resistance: the clock is ticking
Artemisinin resistance in falciparum malaria has emerged in western Cambodia exactly where chloroquine resistance arose 50 years ago. Similarly to the resistance to chloroquine that spread to Africa, the experts are wondering whether artemisinin resistance will spread as widely. In such a case the consequences would be disastrous.Read more