title: An open randomized clinical study of intrarectal versus infused Quinimax for the treatment of childhood cerebral malaria in Niger.
abstract: The intrarectal route has been shown to be an alternative to parenteral therapy for the treatment of acute uncomplicated malaria. We conducted an open randomized clinical study of intrarectal Quinimax (a Cinchona alkaloids association) (20 mg/kg, then 15 mg/kg every 8 h) vs. intravenous Quinimax (8 mg/ kg infused over 4 h every 8 h) for 2 d in 76 children (39 in the intrarectal and 37 in the infusion groups) with cerebral falciparum malaria in Niger. This treatment was followed by oral chloroquine (10 mg/kg/d for 3 d). The primary end points of the study were fatal outcome and coma recovery time. In the intrarectal group, 35 children were cured (90%) and 4 died. In the infused group, 28 were cured (76%) and 9 died; mean coma recovery times were 34.6 h (SD = 12.8) and 33.0 h (SD = 14.1) for the intrarectal and infused groups, respectively. None of the differences was significant. Both treatments were well tolerated and no anal irritation was observed with intrarectal Quinimax. These findings suggest that intrarectal Quinimax can be an alternative to intravenous administration for rapid onset childhood cerebral malaria in the rural tropics, where the safety of parenteral administration cannot be guaranteed.
authors.affiliation: Ministère de la Santé publique du Niger, Niamey, Niger.
authors.forename: H
authors.initials: H
authors.lastname: Barennes
authors.forename: J
authors.initials: J
authors.lastname: Munjakazi
authors.forename: F
authors.initials: F
authors.lastname: Verdier
authors.forename: F
authors.initials: F
authors.lastname: Clavier
authors.forename: E
authors.initials: E
authors.lastname: Pussard
mesh_terms: D000285:Administration, Rectal; D000293:Adolescent; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use; D002930:Cinchona Alkaloids / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D007263:Infusions, Parenteral / Q000592:standards; D016779:Malaria, Cerebral / Q000188:drug therapy*; D009548:Niger; D011802:Quinidine / Q000627:therapeutic use; D011803:Quinine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D002930:Cinchona Alkaloids; D004338:Drug Combinations; D002738:Chloroquine; D011803:Quinine; D011802:Quinidine; C010086:cinchonine