Trial reportMalaria journal2007
Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: a randomized clinical trial.
Trial report in Malaria journal, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 5 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Osmotic therapies added to antibiotics for acute bacterial meningitis.The Cochrane database of systematic reviews · 2018Pooled it
- Clinical features and outcome in children with severe Plasmodium falciparum malaria: a meta-analysis.PloS one · 2014Pooled it
- Osmotic therapies added to antibiotics for acute bacterial meningitis.The Cochrane database of systematic reviews · 2013Pooled it
- Mannitol and other osmotic diuretics as adjuncts for treating cerebral malaria.The Cochrane database of systematic reviews · 2011Pooled it
- The role for osmotic agents in children with acute encephalopathies: a systematic review.BMC pediatrics · 2010Pooled it
- CD8+ T cells target cerebrovasculature in children with cerebral malaria.The Journal of clinical investigation · 2020Trial
- Brain swelling and mannitol therapy in adult cerebral malaria: a randomized trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2011Trial
- Safety of epoietin beta-quinine drug combination in children with cerebral malaria in Mali.Malaria journal · 2009Trial
- DON in pediatric cerebral malaria, a phase I/IIA dose-escalation safety study: study protocol for a clinical trial.Trials · 2024Article
- Exploring adjunctive therapies for cerebral malaria.Frontiers in cellular and infection microbiology · 2024Review
- A Phase I trial of Non-invasive Ventilation and seizure prophylaxis with levetiracetam In Children with Cerebral Malaria Trial (NOVICE-M Trial).Wellcome open research · 2024Article
- Pathogenesis of Cerebral Malaria: New Trends and Insights for Developing Adjunctive Therapies.Pathogens (Basel, Switzerland) · 2023Article
- Recent Advances in Imported Malaria Pathogenesis, Diagnosis, and Management.Current emergency and hospital medicine reports · 2023Review
- Severe malaria.Malaria journal · 2022Review
- Infectious disease-associated encephalopathies.Critical care (London, England) · 2021Review
- Pediatric Cerebral Malaria.Current tropical medicine reports · 2021Article
- Pathophysiology and neurologic sequelae of cerebral malaria.Malaria journal · 2020Review
- Pathophysiology, clinical presentation, and treatment of coma and acute kidney injury complicating falciparum malaria.Current opinion in infectious diseases · 2018Review
- Adjunctive therapy for severe malaria: a review and critical appraisal.Malaria journal · 2018Review
- Lipid metabolites of the phospholipase A2 pathway and inflammatory cytokines are associated with brain volume in paediatric cerebral malaria.Malaria journal · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria.
methodsThis randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects.
resultsTime to regain consciousness (p = 0.11), sit unsupported (p = 0.81), time to start oral intake (p = 0.13) and total coma duration (p = 0.07) were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3%) and mannitol (10/76 or 13.2%) groups: RR = 1.2 (CI 0.5-2.7). No adverse effects were observed after administration of mannitol.
conclusionMannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria.
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