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

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Children treated with artesunate were also less likely to slip into a deeper coma or have seizures after the treatment was started. Severe hypoglycaemia dangerously low blood sugar was also less common in children treated with artesunate. In addition, artesunate was easy to administer, well tolerated, and proved very safe.

Professor White comments: "For over a century, quinine administered by injection has been the best treatment available for treating severe malaria, but thanks to the development of the artemisinin compounds, we now have a safer and much more effective treatment. We recommend that artesunate should now replace quinine for the treatment of severe malaria in both children and adults everywhere in the world."

Artesunate is derived from a Chinese herb called qinghao (Artemisia annua). Nearly forty years ago, Chinese scientists reported that an extract of this herb called was an effective anti-malarial. These reports were treated initially with suspicion but the compounds derived from it (such as artemisinin) have steadily gained acceptance throughout the world. In uncomplicated malaria, artemisinin compounds such as artesunate are now part of the artemisinin-based combination treatments (ACTs) recommended everywhere in the world.

Five years ago the then largest ever trial in patients hospitalized with severe malaria showed that artesunate, given by injection, reduced the death rate compared with quinine. However, this trial was conducted in Asia and most of the patients studied were adults, so there was uncertainty over whether artesunate injection should replace quinine as a treatment of severe malaria in children in Africa, where most of the deaths occur. Today nearly all the children admitted to hospital with severe malaria in Africa still receive quinine.

Dr Arjen Dondorp, Professor White and colleagues from Mahidol University and the University of Oxford, who conducted the original study
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Contact: Craig Brierley
c.brierley@wellcome.ac.uk
44-207-611-7329
Wellcome Trust
Source:Eurekalert

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