Publication: Quinine in severe falciparum malaria: Evidence of declining efficacy in Thailand
Issued Date
1994-01-01
Resource Type
ISSN
18783503
00359203
00359203
Other identifier(s)
2-s2.0-0028291706
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.88, No.3 (1994), 324-327
Suggested Citation
Sasithon Pukrittayakamee, Wichai Supanaranond, Sornchai Looareesuwan, Sirivan Vanijanonta, Nicholas J. White Quinine in severe falciparum malaria: Evidence of declining efficacy in Thailand. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.88, No.3 (1994), 324-327. doi:10.1016/0035-9203(94)90102-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/9602
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Title
Quinine in severe falciparum malaria: Evidence of declining efficacy in Thailand
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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.