Quinine monotherapy for treating uncomplicated malaria in the era of artemisinin-based combination therapy: an appropriate public health policy?
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Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
The Lancet infectious diseases
Abstract
Several African countries that have adopted artemisinin-based combination therapy (ACT) as fi rst-line treatment of
uncomplicated Plasmodium falciparum malaria also use quinine monotherapy as second-line therapy. This policy goes
against WHO recommendations for combination therapy and could be considered an inappropriate public health
policy. Adherence to a 7-day quinine treatment schedule is likely to be poor and may increase the risk of selecting
resistant parasites. Furthermore, because quinine has limited post-treatment prophylaxis, it will not prevent, in areas
of intense transmission, recurrent malaria infections, which can lead to additional morbidity, including anaemia.
Therefore, ACTs and not quinine should be used as second-line treatment, because these are well tolerated, highly
effi cacious, and have the advantage of reducing gametocyte carriage and consequently malaria transmissibility,
particularly in areas of less intense transmission.
Description
Keywords
Quinine monotherapy, Malaria, Treating
Citation
Yeka, A., Achan, J., D'Alessandro, U., & Talisuna, A. O. (2009). Quinine monotherapy for treating uncomplicated malaria in the era of artemisinin-based combination therapy: an appropriate public health policy?. The Lancet infectious diseases, 9(7), 448-452.