Trial reportBMJ (Clinical research ed.)2005
Rectal artemether versus intravenous quinine for the treatment of cerebral malaria in children in Uganda: randomised clinical trial.
Trial report in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Mannitol as Adjunct Therapy on the Clinical Outcome of Childhood Cerebral Malaria in Mulago Hospital: A Randomised Clinical Trial
Efficacy of Intrarectal Versus Intravenous Quinine for the Treatment of Childhood Cerebral Malaria: a Randomized Clinical Trial
Who cites it
23 citing papers in PubMed, 8 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Artemether for severe malaria.The Cochrane database of systematic reviews · 2019Pooled it
- Fever Is Associated with Reduced, Hypothermia with Increased Mortality in Septic Patients: A Meta-Analysis of Clinical Trials.PloS one · 2017Pooled it
- Artemether for severe malaria.The Cochrane database of systematic reviews · 2014Pooled it
- Pre-referral rectal artesunate for severe malaria.The Cochrane database of systematic reviews · 2014Pooled it
- Clinical features and outcome in children with severe Plasmodium falciparum malaria: a meta-analysis.PloS one · 2014Pooled it
- Malaria: severe, life-threatening.BMJ clinical evidence · 2011Pooled it
- Artemisinin derivatives versus quinine for cerebral malaria in African children: a systematic review.Bulletin of the World Health Organization · 2009Pooled it
- Malaria: severe, life-threatening.BMJ clinical evidence · 2007Pooled it
- Efficacy of a novel sublingual spray formulation of artemether in African children with Plasmodium falciparum malaria.Antimicrobial agents and chemotherapy · 2015Trial
- Effect of vitamin A adjunct therapy for cerebral malaria in children admitted to Mulago hospital: a randomized controlled trial.African health sciences · 2012Trial
- Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: a randomized clinical trial.Malaria journal · 2007Trial
- Acceptability and efficacy of intra-rectal quinine alkaloids as a pre-transfer treatment of non-per os malaria in peripheral health care facilities in Mopti, Mali.Malaria journal · 2007Trial
- Safety and efficacy of rectal compared with intramuscular quinine for the early treatment of moderately severe malaria in children: randomised clinical trial.BMJ (Clinical research ed.) · 2006Trial
- Review
- Artemisinins-a Promising New Treatment for Systemic Lupus Erythematosus: a Descriptive Review.Current rheumatology reports · 2018Review
- Cost effectiveness of pre-referral antimalarial treatment in severe malaria among children in sub-Saharan Africa.Cost effectiveness and resource allocation : C/E · 2017Article
- Antimalarial drugs and the prevalence of mental and neurological manifestations: A systematic review and meta-analysis.Wellcome open research · 2017Article
- Malaria in Uganda: challenges to control on the long road to elimination: I. Epidemiology and current control efforts.Acta tropica · 2012Review
- Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria.Malaria journal · 2011Review
- Human immunodeficiency virus infection and cerebral malaria in children in Uganda: a case-control study.BMC pediatrics · 2011Article
Corrections and comments
- Commented on by
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the efficacy and safety of rectal artemether with intravenous quinine in the treatment of cerebral malaria in children.
designRandomised, single blind, clinical trial.
settingAcute care unit at Mulago Hospital, Uganda's national referral and teaching hospital in Kampala.
participants103 children aged 6 months to 5 years with cerebral malaria.
interventionPatients were randomised to either intravenous quinine or rectal artemether for seven days.
main outcome measuresTime to clearance of parasites and fever; time to regaining consciousness, starting oral intake, and sitting unaided; and adverse effects.
resultsThe difference in parasitological and clinical outcomes between rectal artemether and intravenous quinine did not reach significance (parasite clearance time 54.2 (SD 33.6) hours v 55.0 (SD 24.3) hours, P = 0.90; fever clearance time 33.2 (SD 21.9) hours v 24.1(SD 18.9 hours, P = 0.08; time to regaining consciousness 30.1 (SD 24.1) hours v 22.67 (SD 18.5) hours, P = 0.10; time to starting oral intake 37.9 (SD 27.0) hours v 30.3 (SD 21.1) hours, P = 0.14). Mortality was higher in the quinine group than in the artemether group (10/52 v 6/51; relative risk 1.29, 95% confidence interval 0.84 to 2.01). No serious immediate adverse effects occurred.
conclusionRectal artemether is effective and well tolerated and could be used as treatment for cerebral malaria.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.