Intramuscular Artesunate for Severe Malaria in African Children: A Multicenter Randomized Controlled Trial

by Peter G. Kremsner, Akim A. Adegnika, Aurore B. Hounkpatin et al.
PLoS Med 13(1): e1001938 (12 January 2016)

22 pp. 2.0 MB
http://journals.plos.org/plosmedicine/article/asset?
id=10.1371%2Fjournal.pmed.1001938.PDF
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Current artesunate (ARS) regimens for severe malaria are complex. Once daily intramuscular (i.m.) injection for 3 d would be simpler and more appropriate for remote health facilities than the current WHO-recommended regimen of five intravenous (i.v.) or i.m. injections over 4 d. The authors compared both a three-dose i.m. and a three-dose i.v. parenteral ARS regimen with the standard five-dose regimen using a non-inferiority design. They conclude that the simplified three-dose i.m. regimen is non-inferior to the more complex WHO-recommended regimen. Parenteral ARS is associated with a risk of delayed anemia in African children.

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