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Major clinical trial prompts call for change to treatment guidelines for severe malaria worldwide
Date:11/6/2010

The largest ever clinical trial in patients hospitalised with severe malaria has concluded that the drug artesunate should now be the preferred treatment for the disease in both children and adults everywhere in the world. The study, funded by the Wellcome Trust, is published today online in the journal The Lancet.

An international consortium of researchers, led by Professor Nick White of the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme in Bangkok, Thailand, compared treatment with artesunate, which is used in Asia to treat severe malaria, against quinine, which has been in use worldwide for over three hundred years. The trial known as the African Quinine v. Artesunate Malaria Trial (AQUAMAT) was carried out over a five year period in hospitals across nine African countries and studied 5,425 children with severe malaria.

Severe malaria kills nearly a million people each year, mainly young children and pregnant women. It is caused by parasites which are injected into the bloodstream by infected mosquitoes. Severe malaria is often the main reason why children are admitted to hospital in Sub-Saharan Africa, and one in ten of these children die.

For over three centuries, doctors have relied upon the bark of a South American tree to treat tropical fevers. This bark gives quinine, a bitter medicine used to flavour tonic water, prevent night cramps, and cure malaria. Quinine is a reliably effective drug, but it is difficult to give by injection and has unpleasant side effects, some of which are potentially dangerous.

AQUAMAT compared quinine against the more recent drug artesunate both given either intravenously or by intramuscular injection, and showed that treatment with artesunate reduced the number of deaths from severe malaria by 22.5% compared with quinine. With artesunate treatment 8.5% of the patients died, compared to 10.9% with quinine. The results were very similar in all the st
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Contact: Craig Brierley
c.brierley@wellcome.ac.uk
44-207-611-7329
Wellcome Trust
Source:Eurekalert

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