Rectal artemisinins for malaria: a review of efficacy and safety from individual patient data in clinical studies

2008

Review of Rectal Artemisinins for Malaria Treatment

Sample size: 1167 publication 10 minutes Evidence: high

Author Information

Author(s): Gomes Melba, Ribeiro Isabela, Warsame Marian, Karunajeewa Harin, Petzold Max

Primary Institution: World Health Organization

Can rectal artemisinin derivatives provide effective and safe treatment for severe malaria in remote settings?

Rectal artemisinin and artesunate suppositories rapidly eliminate parasites and appear to be safe.

Artemisinin and artesunate treatment cleared parasites more rapidly than parenteral quinine.
A single higher dose of rectal artesunate was five times more likely to achieve >90% parasite reductions at 24 hours.
The study included data from 1167 patients across multiple trials.

This study shows that using rectal artemisinin can help treat malaria quickly, especially in places where injections are hard to get.

Individual patient data from 1167 patients in 15 clinical trials were pooled to compare the efficacy and safety of rectal artemisinin derivatives.

There may be risks of bias due to the variability in study designs and patient demographics.

The study had considerable heterogeneity in dosing schedules and small sample sizes in many trials.

31% of patients were children under 5, 11.8% were aged 6-10, 21.3% were adolescents aged 11-20, and 36% were adults over 20.

p ≤ 0.0001

95% CI 0.32–0.89

p<0.05

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