Abstract:
Objective: To compare the clinical efficacy and safety of rectal dihydroartemisinin (DATM
- Cotecxin) and intravenous quinine in the treatment of severe malaria in children and adults.
Setting: Moi Teaching and Referral Hospital, Eldoret, Kenya between July and November
1998.
Patients: A total of sixty seven patients aged two to sixty years with severe malaria were
studied.
Design: This was an open randomised comparative clinical trial.
Outcome measures: These were parasite clearance time, fever clearance time, efficacy and
the side effect profile of the two drugs.
Results: The two groups were comparable on admission on the clinical and laboratory
parameters. The parasite clearance time was shorter in the rectal DATM group than quinine
group. There was no statistical difference on the fever clearance time and cure rates in the
two groups. The adverse reaction profile was better with rectal DATM than with quinine,
tinnitus observed more in the quinine group.
Conclusion: Rectal DATM is faster in parasite clearance than quinine and is a safe and
convenient alternative to quinine in the treatment of severe malaria.