COMPARISON OF QUININE AND ARTESUNATE IN CEREBRAL MALARIA

ABSTRACT
Objective: To compare Quinine (by intravenous infusion) and Artesunate (by intravenous injection) for the treatment
of cerebral malaria in hospitalized adult patients
Design: Randomized clinical trial
Place and duration of study: Hayatabad Medical complex, January 2016 to December 2016.
Patients and Methods: Twenty cases of cerebral malaria fulfilling the diagnostic criteria of WHO for cerebral Malaria.
These Patients were randomly assigned groups i.e.10 patients in each group. These groups were named Group A and
B. Group A patients were put on Quinine infusion in the standard dosage and group B patients were put on Artesunate
in the standard dosage. Clinical findings were noted on a Performa and the clinical features as well as temperature and
laboratory diagnosis for detection of Falciparum was noted every twelve hours.
Results: In Group A, 7(70%) patients recovered completely while three patients died (30%) while in Group B, 6(60%)
patients recovered while 4 patients (40%) died.
Mean disappearance time of Plasmodium from the blood of Group A was 24 hours and in group B, it was 36 hours.
Mean time for regaining full consciousness with orientation in time space and person and no neurological deficit was
48 hours in quinine treated group and similarly it was 48 hours in Artesunate treated group.
Conclusion: Quinine, intravenously is slightly more effective than intravenous Artesunate in Cerebral Malaria. Due
to small number of patients in the study this difference may not be statistically significant and both drugs should be
considered comparable in efficacy. The deaths are most probably due to late arrival at the hospital with irreversible