Comparing Artemisinin Derivatives and Quinine for Severe Malaria in Children
Author Information
Author(s): PrayGod George, de Frey Albie, Eisenhut Michael
Primary Institution: National Institute for Medical Research, Mwanza, Tanzania
Hypothesis
Are artemisinin derivatives more effective than quinine in treating severe malaria in children?
Conclusion
Artemisinin derivatives do not show lower mortality or long-term morbidity compared to quinine in treating severe malaria in children.
Supporting Evidence
- 12 trials were included in the review with a total of 1,524 subjects.
- There was no significant difference in mortality between artemisinin derivatives and quinine.
- Artemisinin derivatives resolved coma faster than quinine, but this difference disappeared in trials with adequate concealment.
- None of the trials were adequately powered to demonstrate equivalence.
- Future studies require adequately powered equivalence trial designs.
Takeaway
This study looked at two medicines for treating severe malaria in kids and found that neither worked better than the other.
Methodology
The review included randomized controlled trials comparing parenteral artemisinin derivatives with parenteral quinine in children with severe malaria.
Potential Biases
Some trials had unclear allocation concealment and blinding, which may introduce bias.
Limitations
None of the trials were adequately powered to demonstrate equivalence.
Participant Demographics
Participants were children aged 0 to 16 years from various countries including Nigeria, Kenya, and India.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI: 0.73 to 1.12
Digital Object Identifier (DOI)
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