Malaria N° 4 - Subject N° 8

THE OPTIMUM USE OF USE OF QUININE IN THE TREATMENT OF SEVERE MALARIA IN AFRICAN CHILDREN
G. Pasvol & A. Bonington

SUMMARY
Quinine is now the main drug used for the treatment of severe Plasmodium falciparum malaria in Africa. However, most of the studies on quinine have been based on experience in adults in South East Asia. Since the parasite is more sensitive to quinine in Africa than in South East Asia and the volume of distribution of quinine is smaller in children, intravenous regimens with a reduced loading dose (15 mg/kg) and frequency of administration (12 hourly), can currently (1995) be given in most parts of Africa to good effect. The duration of each infusion can be reduced for convenience from 4 to 2 hours. In addition, in situations where intravenous administration is difficult, intramuscular quinine is acceptable as long as it is given under scrupulously sterile conditions, the drug is diluted and the loading dose is split between two anatomical sites. Severe malaria is much in need of both new anti-malarial drugs and adjunctive therapies to reduce the unacceptable mortality of this life-threatening disease.

KEY-WORDS: Plasmodium falciparum, Severe malaria, Treatment, Quinine