The drug artesunate should now be the preferred treatment for the disease in both children and adults everywhere in the world, the largest clinical trial ever conducted has concluded.
Professor Nick White of the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme in Bangkok, Thailand, and his colleagues conducted the trial called African Quinine v. Artesunate Malaria Trial (AQUAMAT).
Artesunate is derived from a Chinese herb called qinghao (Artemisia annua).
AQUAMAT found that treatment with artesunate reduced the number of deaths from severe malaria by 22.5percent compared with quinine. With artesunate treatment 8.5 percent of the patients died, compared to 10.9 percent with quinine.
Children treated with artesunate were also less likely to slip into a deeper coma or have seizures after the treatment was started. Severe hypoglycaemia - dangerously low blood sugar - was also less common in children treated with artesunate. In addition, artesunate was easy to administer, well tolerated, and proved very safe.
"Thanks to the development of the artemisinin compounds, we now have a safer and much more effective treatment. We recommend that artesunate should now replace quinine for the treatment of severe malaria in both children and adults everywhere in the world," Lancet quoted White as saying.
"For those of us who treat malaria in Africa, this trial is a turning point. Finally we have a better treatment to offer to our malaria patients," agreed Dr Olugbenga Mokuolu from the University of Ilorin in Nigeria.
"There are still many hurdles to overcome and we must be vigilant to protect against resistance to these new drugs and against a market in counterfeit drugs. But Professor White and colleagues have shown that we have the potential to save the lives of hundreds of thousands of children," said Sir Mark Walport, Director of the Wellcome Trust, which supported the study.