title: Pentoxifylline as an adjunct therapy in children with cerebral malaria.
abstract: BACKGROUND
  Pentoxifylline (PTX) affects many processes that may contribute to the pathogenesis of severe malaria and it has been shown to reduce the duration of coma in children with cerebral malaria. This pilot study was performed to assess pharmacokinetics, safety and efficacy of PTX in African children with cerebral malaria.
  
  
  METHODS
  Ten children admitted to the high dependency unit of the Kilifi District Hospital in Kenya with cerebral malaria (Blantyre coma score of 2 or less) received quinine plus a continuous infusion of 10 mg/kg/24 hours PTX for 72 hours. Five children were recruited as controls and received normal saline instead of PTX. Plasma samples were taken for PTX and tumour necrosis factor (TNF) levels. Blantyre Coma Score, parasitemia, hematology and vital signs were assessed 4 hourly.
  
  
  RESULTS
  One child (20%) in the control group died, compared to four children (40%) in the PTX group. This difference was not significant (p = 0.60). Laboratory parameters and clinical data were comparable between groups. TNF levels were lower in children receiving PTX.
  
  
  CONCLUSIONS
  The small sample size does not permit definitive conclusions, but the mortality rate was unexpectedly high in the PTX group.
authors.affiliation: KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya. bertrand.lell@uni-tuebingen.de
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lell
authors.forename: Carsten
authors.initials: C
authors.lastname: Köhler
authors.forename: Betty
authors.initials: B
authors.lastname: Wamola
authors.forename: Christopher Ho
authors.initials: CH
authors.lastname: Olola
authors.forename: Esther
authors.initials: E
authors.lastname: Kivaya
authors.forename: Gilbert
authors.initials: G
authors.lastname: Kokwaro
authors.forename: David
authors.initials: D
authors.lastname: Wypij
authors.forename: Sadik
authors.initials: S
authors.lastname: Mithwani
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Taylor
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: Charles R J C
authors.initials: CR
authors.lastname: Newton
mesh_terms: D000962:Antimalarials / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007630:Kenya; D016779:Malaria, Cerebral / Q000188:drug therapy* / Q000401:mortality / Q000469:parasitology / Q000473:pathology; D008297:Male; D018512:Parasitemia / Q000175:diagnosis; D010431:Pentoxifylline / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*; D010949:Plasma / Q000737:chemistry; D011803:Quinine / Q000008:administration & dosage; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics*
chemical_list: D000962:Antimalarials; D014409:Tumor Necrosis Factor-alpha; D014665:Vasodilator Agents; D011803:Quinine; D010431:Pentoxifylline