New Malaria Drug to Save Millions From Death
A new drug named Artesunate has been shown to reduce dealth from malaria by 23% when compared with an older drug called quinine. This can translate into several hundreds of thousands of lives every year in Africa alone. Severe malaria is a major cause of childhood death and often the main reason for paediatric hospital admission in sub-Saharan Africa. The study was published in a recent issue of Lancet.
Quinine is still the established treatment of choice, although evidence from Asia suggests that artesunate is associated with a lower mortality. The study authors compared parenteral treatment with either artesunate or quinine in African children with severe malaria and found that Artesunate substantially reduces mortality in African children
According to Lancet article, Falciparum malaria is a major contributor to child mortality in Africa and one of the main causes of paediatric hospital admission across sub-Saharan Africa. Many deaths occur in or near the home, but for children who are admitted to hospital with severe malaria and receive parenteral antimalarial treatment, about one in six will die.1, 2 From the time of its introduction to European medicine in the 1630s until the deployment of parenteral chloroquine in the 1950s, quinine was the mainstay of severe malaria treatment.
Resistance to chloroquine emerged in southeast Asia and then spread to Africa at the end of the 1970s. Quinine then resumed its primary role in the treatment of severe malaria. Parenteral quinine has a narrow therapeutic ratio. Intravenous quinine administration needs a constant rate infusion with dosing three times a day. Intramuscular administration is painful, and can cause sterile abscesses and predispose to lethal tetanus. Although blindness and deafness may follow self poisoning, these side-effects are rare in severe malaria; however, quinine-induced hyperinsulinaemic hypoglycaemia is a particular problem in patient management, especially in pregnant women.
The article concludes: Artesunate should now become the treatment of choice for severe malaria for children and adults worldwide. Malaria causes an estimated 800 000 deaths every year in African children.40 Severe malaria is often the most common admission diagnosis in febrile children, so a change in treatment policy from quinine to artesunate has the potential to save thousands of children's lives every year. If 4 million African children with severe malaria every year were to receive prompt treatment with parenteral artesunate instead of quinine, and the benefits were similar to those recorded in this trial, then approximately 100 000 lives might be saved per year.
Source: Lancet November 8, 2010