title: Severe and complicated malaria treated with artemisinin, artesunate or artemether in Viet Nam.
abstract: One hundred and seventy five Vietnamese adults with severe and complicated malaria admitted to a rural district hospital were entered into an open randomized comparative study to compare 4 treatment regimens based on artemisinin and its derivatives. The median time of defervescence was 48 h (95% confident interval [CI] 38-58 h) in those given intramuscular (i.m.) artemether, 42 h (95% CI 36-48 h) in those given artemisinin suppositories, 36 h (95% CI 30-42 h) in those receiving artesunate (i.m.) and 30 h (95% CI 18-42 h) in those receiving intravenous artesunate (P = 0.13). The respective median parasite clearance times were 30 h (95% CI 26-34 h), 30 h (95% CI 24-36 h), 24 h (95% CI 15-33 h), and 24 h (95% CI 15-33 h) (P = 0.30); the median times for recovery of consciousness were 47 h (95% CI 31-63 h), 24 h (95% CI 18-30 h), 30 h (95% CI 18-42 h), and 24 h (95% CI 4-44 h) (P = 0.18); and the mortality rates were 11.1%, 17.6%, 10.2% and 16.6%, respectively (P = 0.64). There was no significant difference in efficacy between the 4 treatments.
authors.affiliation: Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Viet Nam.
authors.forename: V
authors.initials: V
authors.lastname: Ha
authors.forename: N H
authors.initials: NH
authors.lastname: Nguyen
authors.forename: T B
authors.initials: TB
authors.lastname: Tran
authors.forename: M C
authors.initials: MC
authors.lastname: Bui
authors.forename: H P
authors.initials: HP
authors.lastname: Nguyen
authors.forename: T H
authors.initials: TH
authors.lastname: Tran
authors.forename: T Q
authors.initials: TQ
authors.lastname: Phan
authors.forename: K
authors.initials: K
authors.lastname: Arnold
authors.forename: T H
authors.initials: TH
authors.lastname: Tran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D000077549:Artemether; D037621:Artemisinins; D000077332:Artesunate; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D016779:Malaria, Cerebral / Q000188:drug therapy* / Q000401:mortality; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012717:Sesquiterpenes / Q000008:administration & dosage; D013488:Suppositories; D016896:Treatment Outcome; D014744:Vietnam
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D013488:Suppositories; D000077332:Artesunate; C031327:artemisinin; D000077549:Artemether