PARASITE VIABILITY DURING TREATMENT OF SEVERE FALCIPARUM-MALARIA - DIFFERENTIAL-EFFECTS OF ARTEMETHER AND QUININE

The effect of artemether (AR) and quinine (QN) on parasite viability e x vivo was compared in children being treated for severe Plasmodium fa lciparum malaria. Parasitized blood taken at intervals during treatmen t was cultured in vitro, and parasite development was assessed microsc opically. Parasite viability (defined as the proportion of circulating rings developing to early schizonts) was 56.8% in the AR group (n = 7 ) 6 hr after the start of treatment, compared with 93.3% for QN (n = 6 ; P = 0.015). Even after 24 hr of QN treatment, parasite viability was not significantly reduced in five patients. These ex vivo findings, w hich confirm previous observations of the stage-specific effects of th ese drugs against P. falciparum, suggest that AR may be superior to QN in the treatment of severe malaria.