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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/9602
Title: Quinine in severe falciparum malaria: Evidence of declining efficacy in Thailand
Authors: Sasithon Pukrittayakamee
Wichai Supanaranond
Sornchai Looareesuwan
Sirivan Vanijanonta
Nicholas J. White
Mahidol University
John Radcliffe Hospital
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1994
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.88, No.3 (1994), 324-327
Abstract: Between 1981 and 1992, 196 Thai adults with severe falciparum malaria were treated with a quinine loading dose regimen. Nineteen patients died (10%) and 6 developed late hypoglycaemia. There was no serious cardiovascular or nervous system toxicity. Although there was no evidence of high grade resistance, and no change in the mortality rate, in recent years an increasing proportion of patients had a delayed clinical and parasitological response to treatment. Since 1988, 78% (29/37) of patients with cerebral malaria were unconscious for > 72 h compared with 41% (11/27) between 1981 and 1987 (P = 0·002). In the past 2 years parasite clearance times have exceeded 96 h in 33% (26/78) of patients compared with 14% (15/102) previously (P = 0·006). Quinine remains an effective treatment for severe multi-drug resistant falciparum malaria in this area, but there is now evidence of a decline inthe immediate therapeutic response, and its efficacy will need close monitoring as resistance increases further. © 1994 Oxford University Press.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0028291706&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/9602
ISSN: 18783503
00359203
Appears in Collections:Scopus 1991-2000

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