Comparison of chloroquine with quinimax in the treatment of cerebral malaria in Ghanaian children
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Date
2003-09
Journal Title
Journal ISSN
Volume Title
Publisher
Ghana Medical Journal
Abstract
Despite earlier reports of R2 and R3 resistance of
Plasmodium,1 falciparum to chloroquine. it remained the drug of choice for the treatment of
cerebra1 malaria in Ghana. The World Health Organization, however, recommends the use of parenteral
quinine salts in such circumstances.
In order to guide local treatment policies, an open
randomized trial comparing the effect of enteral
chloroquine and intravenous followed by oral
Quinimax. a quinine preparation approved by the
World Health Organization was conducted in 70
children with cerebral malaria. The primary endpoints were mortality, prevalence of residual neurologic sequalae and treatment failure (clinical and
parasitological).
Thirty-three patients received chloroquine and 37
received Quinimax"'. There was no significant
difference in mortality rates (chlorO(IUine. 12.1 %;
Quinimax 10.8%; p= 1.00) and neurologic sequelae
on day 7 (chloroquine. 12.1%; Quinimax ·,
8.1%; p: O.70) . There was a significantly higher
prevalence of early treatment failure in the chloroqU111e
group (chloroquine, 12.1 %; Quinimax®. 0%;
1)-"-0.045). Significantly more patients on chloroquine
were parasitaemia on day 3 (chloroquine,
21.8%; Qumimax ~. 2.7%; p 0.022) but times to
parasite clearance. fever clearance and recovery of
full consciousness were similar.
We conclude that treatment failure is more likely
when chloroquine is used to treat cerebral malaria
th'111 when Quinimax® is used. We therefore recommend
that quinine salts, or other antimalarial
110
drugs of equal efficacy be used to treat cerebral
malaria in Ghanaian children instead of chloroquine.
Description
Journal Article
Keywords
Chloroquine, Quinimax, quinine, Cerebral Malaria, children