SynthesisMalaria journal2008
Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review.
Synthesis in Malaria journal, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 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
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Pooled it
- Artemether for severe malaria.The Cochrane database of systematic reviews · 2019Pooled it
- Malaria: severe, life-threatening.BMJ clinical evidence · 2011Pooled it
- Pharmacokinetic interactions between ritonavir and quinine in healthy volunteers following concurrent administration.British journal of clinical pharmacology · 2010Trial
- Safety of epoietin beta-quinine drug combination in children with cerebral malaria in Mali.Malaria journal · 2009Trial
- Effects of concurrent administration of nevirapine on the disposition of quinine in healthy volunteers.The Journal of pharmacy and pharmacology · 2009Trial
- Review
- CYP450 phenotyping and metabolite identification of quinine by accurate mass UPLC-MS analysis: a possible metabolic link to blackwater fever.Malaria journal · 2013Article
- Cost-effectiveness of pre-referral antimalarial, antibacterial, and combined rectal formulations for severe febrile illness.PloS one · 2010Article
- Adjunctive therapy for cerebral malaria and other severe forms of Plasmodium falciparum malaria.Expert review of anti-infective therapy · 2010Review
- Is chloroquine better than artemisinin combination therapy as first line treatment in adult nigerians with uncomplicated malaria?-A cost effectiveness analysis.African journal of infectious diseases · 2010Article
- Discovery, mechanisms of action and combination therapy of artemisinin.Expert review of anti-infective therapy · 2009Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria in children is not clearly understood. The objective of this review was to assess the efficacy of parenteral artemisinin derivatives versus parenteral quinine in treating severe malaria in children.
methodsAll randomized controlled studies comparing parenteral artemisinin derivatives with parenteral quinine in treating severe malaria in children were included in the review. Data bases searched were: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007), MEDLINE (1966 to February 2008), EMBASE (1980 to February 2008), and LILACS (1982 to February 2008). Dichotomous variables were compared using risk ratios (RR) and the continuous data using weighted mean difference (WMD).
resultsTwelve trials were included (1,524 subjects). There was no difference in mortality between artemisinin derivatives and quinine (RR = 0.90, 95% CI 0.73 to 1.12). The artemisinin derivatives resolved coma faster than quinine (WMD = -4.61, 95% CI: -7.21 to -2.00, fixed effect model), but when trials with adequate concealment only were considered this differences disappeared. There was no statistically significant difference between the two groups in parasite clearance time, fever clearance time, incidence of neurological sequelae and 28th day cure rate. One trial reported significantly more local reactions at the injection site with intramuscular quinine compared to artemether. None of the trials was adequately powered to demonstrate equivalence.
conclusionThere was no evidence that treatment of children with severe malaria with parenteral artemisinin derivatives was associated with lower mortality or long-term morbidity compared to parenteral quinine. Future studies require adequately powered equivalence trial design to decide whether both drugs are equally effective.
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.