Publication: The management of patients with severe malaria
Issued Date
2007-12-01
Resource Type
ISSN
00029637
Other identifier(s)
2-s2.0-40049111417
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.77, No.SUPPL. 6 (2007), 29-35
Suggested Citation
Nicholas Day, Arjen M. Dondorp The management of patients with severe malaria. American Journal of Tropical Medicine and Hygiene. Vol.77, No.SUPPL. 6 (2007), 29-35. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/24481
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Title
The management of patients with severe malaria
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Abstract
Severe malaria is a global problem, claiming at least 1 million lives annually. Few adequately powered clinical studies have been directed at improving the management of severe malaria over the years, but this situation is slowly changing. The antimalarial treatment of severe disease is being transformed by the development and deployment of the water-soluble artemisinin derivative artesunate. Parenteral artesunate is now the treatment of choice in lowtransmission areas and in the 2nd and 3rd trimesters of pregnancy, and research is underway into whether it should replace quinine as the treatment of choice in African children. Development of good manufacturing practice (GMP) formulations should make parenteral artesunate more widely available in the near future. The development of artesunate suppositories offers another exciting prospect, the ability to treat patients with severe disease in remote rural settings, delaying the evolution of disease and buying them time to reach a health care facility. No adjunctive therapy has been shown to improve the outcome of severe malaria, but most studies have been underpowered. Future trials of interventions shown to be promising in pilot studies should be large and adequately powered. This will require multicenter designs and necessitate close collaboration between groups, as well as agreement on the research agenda. We suggest a list of candidate interventions for debate. Copyright © 2007 by The American Society of Tropical Medicine and Hygiene.