Trial reportThe Journal of infectious diseases2014
Randomized controlled trial of levamisole hydrochloride as adjunctive therapy in severe falciparum malaria with high parasitemia.
Trial report in The Journal of infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis 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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Outcomes reported in trials of treatments for severe malaria: The need for a core outcome set.Tropical medicine & international health : TM & IH · 2022Pooled it
- A review of bloodstream infections-pathogens, pathogenesis, diagnostic strategies, treatment methods-challenges and future aspects.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- Management and monitoring strategies for severe cerebral malaria: a guide for the intensivist.Annals of intensive care · 2025Review
- Pediatric Cerebral Malaria.Current tropical medicine reports · 2021Article
- Bioengineered 3D Microvessels for Investigating Plasmodium falciparum Pathogenesis.Trends in parasitology · 2021Review
- A fatal case after an intravenous injection of levamisole.Forensic science, medicine, and pathology · 2021Article
- Pathophysiology and neurologic sequelae of cerebral malaria.Malaria journal · 2020Review
- Article
- Safety and Efficacy of Adjunctive Therapy With Artesunate in the Treatment of Severe Malaria: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2020Review
- Investigating causal pathways in severe falciparum malaria: A pooled retrospective analysis of clinical studies.PLoS medicine · 2019Article
- Adjunctive therapy for severe malaria: a review and critical appraisal.Malaria journal · 2018Review
- Variant surface antigens of Plasmodium falciparum and their roles in severe malaria.Nature reviews. Microbiology · 2017Review
- New frontiers in the treatment of colorectal cancer: Autophagy and the unfolded protein response as promising targets.Autophagy · 2017Review
- Article
- Development of drugs for severe malaria in children.International health · 2016Article
- UK malaria treatment guidelines 2016.The Journal of infection · 2016Article
- Population pharmacokinetics of levamisole in children with steroid-sensitive nephrotic syndrome.British journal of clinical pharmacology · 2015Article
- The influence of host genetics on erythrocytes and malaria infection: is there therapeutic potential?Malaria journal · 2015Review
- Slow Clearance of Plasmodium falciparum in Severe Pediatric Malaria, Uganda, 2011-2013.Emerging infectious diseases · 2015Article
- Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 7 institutions in 6 countries.
Funding
Abstract
backgroundCytoadherence and sequestration of erythrocytes containing mature stages of Plasmodium falciparum are central to the pathogenesis of severe malaria. The oral anthelminthic drug levamisole inhibits cytoadherence in vitro and reduces sequestration of late-stage parasites in uncomplicated falciparum malaria treated with quinine.
methodsFifty-six adult patients with severe malaria and high parasitemia admitted to a referral hospital in Bangladesh were randomized to receive a single dose of levamisole hydrochloride (150 mg) or no adjuvant to antimalarial treatment with intravenous artesunate.
resultsCirculating late-stage parasites measured as the median area under the parasite clearance curves were 2150 (interquartile range [IQR], 0-28 025) parasites/µL × hour in patients treated with levamisole and 5489 (IQR, 192-25 848) parasites/µL × hour in controls (P = .25). The "sequestration ratios" at 6 and 12 hours for all parasite stages and changes in microvascular blood flow did not differ between treatment groups (all P > .40). The median time to normalization of plasma lactate (<2 mmol/L) was 24 (IQR, 12-30) hours with levamisole vs 28 (IQR, 12-36) hours without levamisole (P = .15).
conclusionsThere was no benefit of a single-dose of levamisole hydrochloride as adjuvant to intravenous artesunate in the treatment of adults with severe falciparum malaria. Rapid parasite killing by intravenous artesunate might obscure the effects of levamisole.
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.