E-DRUG: Rectal artemisinine for cerebral malaria
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Dear E-druggers,
I should like to draw your attention to an interesting study done in the university hospital in Kampala (Uganda) and published in todays British Medical Journal.. Children with cerebral malaria were treated (double blind) with either artemether soft gel capsules for rectal application or with quinine infusions. The new drug formulation is particulalry suited for home treatment by mothers whose children suffer from complicated malaria.
Editor's choice of BMJ, 12th February 2005:
(5) SIMPLE TREATMENT COULD PREVENT MANY CHILD MALARIA DEATHS
(Rectal artemether versus intravenous quinine for the treatment of cerebral
malaria in children in Uganda: randomised clinical trial)
http://bmj.com/cgi/content/full/330/7487/334
(Editorial: Rectal artemether and intravenous quinine for treating severe
malaria)
http://bmj.com/cgi/content/full/330/7487/317
A simple drug, given to children with severe malaria before they reach
hospital, has the potential to save many lives, say researchers in this
week's BMJ.
Every year over a million children die of malaria in Africa. The majority
of fatalities occur outside hospital, especially in rural areas. For those
who do make it to hospital, half of deaths occur within 24 hours of
admission.
Conventional treatment, given by injection, is not possible to administer
outside hospital, so buying time by starting treatment which is easy to
administer in the community is crucial.
Researchers in Uganda compared the effectiveness and safety of conventional
treatment (intravenous quinine) with an alternative treatment (artemether,
given as a suppository) in 103 children aged between 6 months and 5 years
with severe malaria.
They found the two treatments broadly comparable and suggest that rectal
artemether could be used to treat severe malaria where qualified staff and
equipment for intravenous therapy is not available.
These are encouraging results, say experts in an accompanying editorial.
Although a single trial of this size cannot alone be the basis for policy
change, rectal artemisinins might be one safe and effective way to reduce
the risk of children dying before reaching hospital.
Providing effective antimalarial treatment close to home to reduce delay
has the potential to save many lives, they conclude.
Contacts:
Paper: James Tumwine, Associate Professor, Department of Paediatrics and
Child Health, Makerere Medical School, Kampala, Uganda
Email: jtumwine@imul.com
Editorial: Christopher Whitty, Senior Lecturer, Department of Infectious
and Tropical Diseases, London School of Hygiene and Tropical Medicine,
London, UK
Email: christopher.whitty@lshtm.ac.uk
Sincerely yours,
Dr. F.H. Jansen
30 Witte Bremlaan
2360 Oud-Turnhout
Belgium
Fhjansen@skynet.be