Effectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trial

Simple item page
dc.contributor.authorAchan, Jane
dc.contributor.authorTibenderana, James K.
dc.contributor.authorKyabayinze, Daniel
dc.contributor.authorWabwire Mangen, Fred
dc.contributor.authorKamya, Moses R.
dc.contributor.authorDorsey, Grant
dc.contributor.authorD’Alessandro, Umberto
dc.contributor.authorRosenthal, Philip J.
dc.contributor.authorTalisuna, Ambrose O.
dc.date.accessioned2021-12-11T08:11:40Z
dc.date.available2021-12-11T08:11:40Z
dc.date.issued2009
dc.description.abstractObjective To compare the effectiveness of oral quininewith that of artemether-lumefantrine in treatinguncomplicated malaria in children.Design Randomised, open label effectiveness study.Setting Outpatient clinic of Uganda’s national referral hospital in Kampala.Participants 175 children aged 6 to 59 months withuncomplicated malaria.Interventions Participants were randomised to receiveoral quinine or artemether-lumefantrine administered bycare givers at home.Main outcome measures Primary outcomes wereparasitological cure rates after 28 days of follow-upunadjusted and adjusted by genotyping to distinguishrecrudescence from new infections. Secondary outcomeswere adherence to study drug, presence of gametocytes, recovery of haemoglobin concentration from baseline at day 28, and safety profiles.Results Using survival analysis the cure rate unadjustedby genotyping was 96% for the artemether-lumefantrinegroup compared with 64% for the quinine group (hazardratio10.7, 95% confidence interval 3.3 to 35.5, P=0.001).In the quinine group 69% (18/26) of parasitologicalfailures were due to recrudescence compared with none inthe artemether-lumefantrine group. The mean adherenceto artemether-lumefantrine was 94.5% compared with85.4% to quinine (P=0.0008). Having adherence levels of80% or more was associated with a decreased risk oftreatment failure (0.44, 0.19 to 1.02, P=0.06). Adverseevents did not differ between the two groups.ConclusionsThe effectiveness of a seven day course ofquinine for the treatment of uncomplicated malariainUgandanchildren was significantly lower than that ofartemether-lumefantrine. These findings question theadvisability of the recommendation for quinine therapyfor uncomplicated malaria in Africa.Trial registration ClinicalTrials.gov NCT00540202.en_US
dc.identifier.citationAchan, J., Tibenderana, J. K., Kyabayinze, D., Mangen, F. W., Kamya, M. R., Dorsey, G., ... & Talisuna, A. O. (2009). Effectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trial. Bmj, 339.doi:10.1136/bmj.b2763en_US
dc.identifier.other10.1136/bmj.b2763
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/280
dc.language.isoenen_US
dc.publisherBmjen_US
dc.subjectQuinineen_US
dc.subjectArtemether-lumefantrineen_US
dc.subjectTreatingen_US
dc.subjectFalciparum malariaen_US
dc.titleEffectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trialen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Effectiveness of quinine versus artemether-lumefantrine for.pdf
Size:
214.25 KB
Format:
Adobe Portable Document Format
Description:
Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences