Trial reportPloS one2013
Efficacy of quinine, artemether-lumefantrine and dihydroartemisinin-piperaquine as rescue treatment for uncomplicated malaria in Ugandan children.
Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Pooled it
- Dihydroartemisinin-piperaquine for treating uncomplicated Plasmodium falciparum malaria.The Cochrane database of systematic reviews · 2014Pooled it
- Trial
- Piperaquine concentration and malaria treatment outcomes in Ugandan children treated for severe malaria with intravenous Artesunate or quinine plus Dihydroartemisinin-Piperaquine.BMC infectious diseases · 2019Trial
- Clinical Efficacy of Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria at the China-Myanmar Border.The American journal of tropical medicine and hygiene · 2015Trial
- Prevalence of resistance markers of artemisinin, partner drugs, and sulfadoxine-pyrimethamine in Nanyumbu and Masasi Districts, Tanzania between 2020 and 2021.Antimicrobial agents and chemotherapy · 2025Article
- Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data.BMC medicine · 2022Article
- Global estimation of anti-malarial drug effectiveness for the treatment of uncomplicated Plasmodium falciparum malaria 1991-2019.Malaria journal · 2020Article
- Impact of substandard and falsified antimalarials in Zambia: application of the SAFARI model.BMC public health · 2020Article
- Poor-quality antimalarials further health inequities in Uganda.Health policy and planning · 2019Article
- Development of an agent-based model to assess the impact of substandard and falsified anti-malarials: Uganda case study.Malaria journal · 2019Article
- The economic impact of substandard and falsified antimalarial medications in Nigeria.PloS one · 2019Article
- Plasmodium falciparum HRP2 ELISA for analysis of dried blood spot samples in rural Zambia.Malaria journal · 2017Article
- Comparison of anti-malarial drugs efficacy in the treatment of uncomplicated malaria in African children and adults using network meta-analysis.Malaria journal · 2017Article
- Absence of in vivo selection for K13 mutations after artemether-lumefantrine treatment in Uganda.Malaria journal · 2017Article
- Budget Impact Analysis of Using Dihydroartemisinin-Piperaquine to Treat Uncomplicated Malaria in Children in Tanzania.PharmacoEconomics · 2016Article
- An Economic Evaluation of the Posttreatment Prophylactic Effect of Dihydroartemisinin-Piperaquine Versus Artemether-Lumefantrine for First-Line Treatment of Plasmodium falciparum Malaria Across Different Transmission Settings in Africa.The American journal of tropical medicine and hygiene · 2015Article
- Plasmodium falciparum susceptibility to standard and potential anti-malarial drugs in Dakar, Senegal, during the 2013-2014 malaria season.Malaria journal · 2015Article
- Multinormal in vitro distribution of Plasmodium falciparum susceptibility to piperaquine and pyronaridine.Malaria journal · 2015Article
- Stability profiling of anti-malarial drug piperaquine phosphate and impurities by HPLC-UV, TOF-MS, ESI-MS and NMR.Malaria journal · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe treatment of falciparum malaria poses unique challenges in settings where malaria transmission intensity is high because recurrent infections are common. These could be new infections, recrudescences, or a combination of the two. Though several African countries continue to use quinine as the second line treatment for patients with recurrent infections, there is little information on its efficacy when used for rescue therapy. Moreover, such practice goes against the World Health Organisation (WHO) recommendation to use combination therapy for uncomplicated malaria.
methodsWe conducted a nested, randomized, open label, three-arm clinical trial of rescue therapy in children 6-59 months old with recurrent malaria infection during 28 days post treatment with artemisinin combination treatment (ACT). Patients were randomly assigned to receive either quinine, artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DHAPQ), and actively followed up for 28 days.
findingsAmong 220 patients enrolled, 217 (98·6%) were assigned an efficacy outcome and 218 (99·1%) were assessed for safety. The risk of recurrent infection was significantly higher in patients treated with quinine (70%, 74/110, HR = 3·9; 95% CI: 2·4-6·7, p<0·0001) and AL (60%, 21/35, HR = 3·3; 95% CI: 1·8-6·3, p<0·0002), compared to DHAPQ (25%, 18/72). Recrudescence tended to be lower in the DHAPQ (1%, 1/72) than in the quinine (7%, 8/110) or AL (6%, 2/35) group, though it was not statistically significant. No serious adverse events were reported.
conclusionRecurrent infections observed after the administration of an ACT can be successfully treated with an alternative ACT rather than with quinine.
trial registrationCurrent Controlled Trials ISRCTN99046537.
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.