Evaluation of Efficacy and Safety of Artemisinin Derivatives Comparison with Quinine in Paediatric Population for Treatment of Severe Malaria: A Meta-Analysis Approach

Abstract

Artemisinin and its derivatives such as artesunate, arteether and artemether are the primary and effective treatment of choice as per WHO malaria treatment guideline for the treatment of severe malaria although various endemic countries are using quinine for the treatment of severe malaria. The objective of this meta- analysis was to evaluate the efficacy and safety of artemisinin and its derivatives compared with quinine as parenteral antimalarial therapy for treating severe malaria in children. From the year 1990 to the year 2015, studies were identified using database searches, citation searches of selected articles. The electronic databases searched engines: Pubmed, Web of Science, Global Health, Medline and Cochrane review of Journals up to April 2015. We selected published randomized controlled clinical trials (RCTs) information comparing artemisinin derivatives with quinine and route of administration was either intravenous or intramuscular for treatment of severe malaria in paediatric population as per WHO malaria treatment guideline, any gender, age group up to 15 years of children who were diagnosed with confirmed malaria by RDT or slide test. The primary outcome was efficacy in terms of parasite clearance time (PCT) and fever clearance time (FCT) in paediatrics population. The secondary outcome was the mortality, coma resolution time (CRT) and neurological sequelae at the time of discharge in the paediatric population. We assessed identified articles on the basis of clinical trial eligibility, the risk of bias and extracted data as per objective of this research for the desired outcomes.