Artesunate versus Quinine in the Treatment of Severe Plasmodium falciparum Malaria at North Eastern of Democratic Republic of Congo: Parasites and Fever Clearance

Abstract

Severe malaria is one of the leading causes of death in sub-Saharan African countries and Artesunate is the firstline choice recommended treatment by the World Health Organization. The objective of this study was to identify biological and clinical advantages of Artesunate compared to Quinine in the treatment of severe malaria in children. This study was a randomized and analytical study focused on children admitted to Pediatric Hospital Center Village of Kisangani with severe falciparum malaria, from January 1, 2015 to December 31, 2017. We assigned individuals children intravenous Artesunate 2.4 mg/kg given as a bolus (n=34) at 0, 12, 24 hours and then daily or Quinine 20 mg/kg infused in 5 or 10% Dextrose over 4 hours than 10 mg/kg infused every 8 hours (n=83). During our study period, a total of 117 children were included in the study. 34 were treated with Artesunate while 83 were treated with Quinine. The higher malaria parasites clearance average 1063174 Parasites/ µL (971 Parasites/ µL - 1563 400 Parasites/ µL) concerned the preschool age. The malaria parasites clearance on 12 hours after administration of Artesunate was similar (79.1%) compared with 79.1% clearance obtained by using quinine. The fever clearance of children treated with Artesunate and Quinine was higher in the Artesunate group (91.2%) than in the Quinine group (88%) on 12 hours with significant statistic difference. This study concluded that Artesunate and Quinine present a similar clinic and biologic efficiency