FALCIPARUM MALARIA

COMPARISON OF RESPONSE TO TREATMENT BETWEEN QUININE AND ARTEMETHER

Abstract

Introduction: Quinine and quinidines remain the drugs of choice for chloroquine resistant Plasmodium falciparum malaria. In 1972, Chinese scientists discovered the antimalarial properties of a group of compounds from the qinghao plant (Artemisia annua) which have activity against all malaria causing parasites including multi-drug resistant strains of Plasmodium falciparum. Objective: To compare response to treatment between quinine and artemether in Plasmodium falciparum malaria. Design: Quasi-experimental study. Setting: Department of Medicine Pakistan Air Force Hospital Lahore. Period: 1st Jun 2008 to 1st Dec 2009. Patients: 80 consecutive adult patients with positive MP slide for Plasmodium falciparum malaria. Methods: Patients were randomly divided into two groups for treatment either with quinine or artemether. Results: Out of total 80 patients, 40 were given quinine and 40 were given artemether. Out of 40, 16 patients responded to quinine while 24 did not respond. The responders were 34.8% in case of quinine while 70.6% patients did not respond. Out of 40 patients treated with artemether, 30 responded while 10 did not. The responders were 65.2%while non responders were 29.4%.0n calculating the P-value from the chi-square it was found that difference in terms of response to the two treatment regimens was statistically significant.(P=.0022).Conclusion: The frequency of response in case of quinine was 34.8% while it was 65.2% in case of artemether. So based upon statistically significant difference (P=.0022) it is concluded that Artemether is a satisfactory alternative to Quinine for the treatment of falciparum malaria in adults.