title: Parasite viability during treatment of severe falciparum malaria: differential effects of artemether and quinine.
abstract: The effect of artemether (AR) and quinine (QN) on parasite viability ex vivo was compared in children being treated for severe Plasmodium falciparum malaria. Parasitized blood taken at intervals during treatment was cultured in vitro, and parasite development was assessed microscopically. Parasite viability (defined as the proportion of circulating rings developing to early schizonts) was 56.8% in the AR group (n = 7) 6 hr after the start of treatment, compared with 93.3% for QN (n = 6; P = 0.015). Even after 24 hr of QN treatment, parasite viability was not significantly reduced in five patients. These ex vivo findings, which confirm previous observations of the stage-specific effects of these drugs against P. falciparum, suggest that AR may be superior to QN in the treatment of severe malaria.
authors.affiliation: Kenya Medical Research Institute, Kilifi Research Unit.
authors.forename: S
authors.initials: S
authors.lastname: Murphy
authors.forename: W M
authors.initials: WM
authors.lastname: Watkins
authors.forename: P G
authors.initials: PG
authors.lastname: Bray
authors.forename: B
authors.initials: B
authors.lastname: Lowe
authors.forename: P A
authors.initials: PA
authors.lastname: Winstanley
authors.forename: N
authors.initials: N
authors.lastname: Peshu
authors.forename: K
authors.initials: K
authors.lastname: Marsh
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000494:pharmacology / Q000627:therapeutic use*; D000077549:Artemether; D037621:Artemisinins; D002648:Child; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000469:parasitology*; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000502:physiology; D011803:Quinine / Q000494:pharmacology / Q000627:therapeutic use*; D012717:Sesquiterpenes / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D011803:Quinine; D000077549:Artemether