Team McCallum

R&D for Lifetime of Life

Bye, quinine. Hi, artesunate!

Five years ago a team of doctors reported in the Lancet on the South East Asian Quinine Artesunate Malaria Trial. Adults with severe malaria in Bangladesh, India, Indonesia and Myanmar were randomly assigned to either quinine or artesunate. Artesunate resulted in 35% fewer deaths than quinine, while the latter had a three-fold higher risk of producing very low blood sugar levels.

However, the main victims of malaria are pregnant women and children.

Now, the same research team has returned to the Lancet to report on a trial in children in Africa – the African Quinine Artesunate Malaria Trial. This 5 year trial covered 9 sub-Saharan countries and over 5,400 children with severe malaria.

Once more, artesumate was clearly superior, resulting in 23% fewer deaths and again cutting the risk of getting dangerous blood sugar levels.

The team concluded that the drug artesunate should now be the preferred treatment for the disease in both children and adults everywhere in the world.

So it’s goodbye to quinine, which everyone knows is plant-based, derived from the bark of a South American tree. This has been used for over 300 years, as it is fairly effective, though it can have dangerous side-effects.

And it’s hello to artesunate, which the Chinese know is derived from a plant, in this case a herb called qinghao (Artemissia annua), also known as wormwood. It has been used in Chinese herbal medicine for centuries to treat chills and fever and Chinese scientists first suggested its use for malaria about 40 years, but Western scientists were sceptical. 

Today nearly all the children admitted to hospital with severe malaria in Africa still receive quinine. According to Dr Olugbenga Mokuolu, who comes from one of the 11 sites collaborating in the trial, “If half of the estimated eight million children annually who suffer from the disease could be treated with injectable artesunate, we could potentially save 100,000 young lives each year.”

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November 7, 2010 - Posted by | Artesunate, Child Health, Malaria, Quinine, Success

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