COMPARISON OF OUTCOME OF ARTESUNATE WITH QUININE IN CEREBRAL MALARIA; EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN PESHAWAR

Abstract

Malaria remains a tremendous health burden in tropical regions, causing up to 24.3 billion episodes of clinical illness and 0.86 million deaths in 2009, with annual death rates of up to 93% in severe malaria. This study aims to compare the outcome of artesunate with quinine in cerebral malaria. This Randomized Controlled Trial was conducted in the Department of Medicine, Lady Reading Hospital, Peshawar, from December 2021 to January 2023. This study was conducted on 102 patients with cerebral malaria aged 12 to 60 years of age of either gender. Patients were divided into two groups: group A received artesunate, while Group B received quinine for cerebral malaria. Outcome in terms of in-hospital mortality and mortality at follow-up was assessed between both groups. According to the in hospital treatment outcome, the mortality rate in group A (Artesunate) was 3 (5.9%) while 10 (19.6%) in group B (Quinine), the in hospital treatment outcome (mortality) was significantly lower in group A as compared to group B (P = 0.03). According to the outcome at follow-up, the mortality rate in group A was 4 (7.8%) while 12 (23.5%) in group B, the outcome (mortality) at follow-up was significantly lower in group A as compared to group B (P = 0.02). From our study, we conclude that the outcome in terms of in-hospital mortality was significantly lower in artesunate group as compared to quinine group (P = 0.03), and mortality at follow-up was also significantly lower in artesunate group as compared to quinine group (P = 0.02) in cerebral malaria.