ArticleBMC infectious diseases2010
Hypoglycaemia in severe malaria, clinical associations and relationship to quinine dosage.
Article in BMC infectious diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Prognostic models for the clinical management of malaria and its complications: a systematic review.BMJ open · 2019Pooled it
- Clinical and laboratory predictors of death in African children with features of severe malaria: a systematic review and meta-analysis.BMC medicine · 2017Pooled it
- Trial
- Non-Diabetic Hypoglycemia: Evaluation and Management in Adults.Journal of clinical medicine · 2025Review
- Recent Advances in the Treatment of Malaria.Pharmaceutics · 2024Review
- Defining the next generation of severe malaria treatment: a target product profile.Malaria journal · 2024Review
- Malaria parasitaemia and its impact on biological parameters among children <16 years old attending the Nkwen District Hospital, Cameroon.MalariaWorld journal · 2024Article
- 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
- SEVUparin as a potential Adjunctive Treatment in children with severe malaria: A phase I trial safety and dose finding trial (SEVUSMAART).Wellcome open research · 2023Article
- Effect of Brugia pahangi co-infection with Plasmodium berghei ANKA in gerbils (Meriones unguiculatus).Parasitology research · 2020Article
- Continuous Glucose Monitoring in Resource-Constrained Settings for Hypoglycaemia Detection: Looking at the Problem from the Other Side of the Coin.Biosensors · 2018Article
- 'We just dilute sugar and give' health workers' reports of management of paediatric hypoglycaemia in a referral hospital in Malawi.Global health action · 2018Article
- The activation of αThe Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2017Article
- Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu.BMC pediatrics · 2017Article
- Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique.Malaria journal · 2017Article
- Effect of D-glucose feeding on mortality induced by sepsis.The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2016Article
- Management of severe paediatric malaria in resource-limited settings.BMC medicine · 2015Review
- Complex Membrane Channel Blockade: A Unifying Hypothesis for the Prodromal and Acute Neuropsychiatric Sequelae Resulting from Exposure to the Antimalarial Drug Mefloquine.Journal of parasitology research · 2015Review
- Improving the management of dysglycemia in children in the developing world.The American journal of tropical medicine and hygiene · 2015Article
- Population pharmacokinetic and pharmacodynamic properties of intramuscular quinine in Tanzanian children with severe Falciparum malaria.Antimicrobial agents and chemotherapy · 2013Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundHypoglycaemia is an independent risk factor for death in severe malaria and a recognized adverse treatment effect of parenteral quinine. In 2006 our hospital changed quinine treatment policy from 15 mg/kg loading (plus 10 mg/kg 12-hourly) to 20 mg/kg loading (plus 10 mg/kg 8-hourly) to comply with new WHO guidelines. This presented us with the opportunity to examine whether there was any dose relationship of quinine and hypoglycaemia occurrence.
methodsRetrospective case notes review of all children admitted to hospital with severe falciparum malaria between April 2002 - July 2009, before and after the introduction of the new WHO quinine regimen. Four-hourly bedside glucose levels were measured until intravenous quinine was discontinued. Clinical events immediately preceding or concurrent with each episode of hypoglycaemia (glucose < = 3.0 mmol/l) were recorded.
results954 children received the old quinine regime and 283 received the new regime. We found no evidence of an increased prevalence of hypoglycaemia (< = 3.0 mmol/L) on the new regime compared to former (15% vs. 15%); similar findings were noted for profound hypoglycaemia (< 2.2 mmols/L) 8% v 5%, P = 0.07. Episodes were co-incident with disease severity markers: coma (57%), circulatory failure (38%) and respiratory distress (21%) but less commonly with seizures (10%). Disruption of maintenance fluids and/or blood transfusion concurred with 42% of the hypoglycaemia episodes. Post admission hypoglycaemia increased odds of fatal outcome (24%) compared to euglycaemic counterparts (8%), odds ratio = 3.45 (95% confidence interval = 2.30-5.16) P < 0.01.
conclusionThere was no evidence to indicate a dose relationship between quinine and occurrence of hypoglycaemia. Hypoglycaemia concurred with severity features, disruption of glucose infusion and transfusion. Careful glucose monitoring should be targeted to these complications where resources are limited.
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