Bq. Goka et al., Comparison of chloroquine with artesunate in the treatment of cerebral malaria in Ghanaian children, J TROP PEDI, 47(3), 2001, pp. 165-169
Despite previously reported chloroquine-resistant forms of P. falciparum in
Ghana, chloroquine remains the drug of choice in severe malaria. Artemisin
in derivatives have been shown to be effective against chloroquine-resistan
t strains in other endemic areas. This open randomized study was conducted
to compare the efficacy of chloroquine and artesunate in the treatment of c
hildhood cerebral malaria. Out of 82 subjects that fulfilled the inclusion
criteria, 36 were randomized to receive chloroquine and 46 to receive artem
isinin. Blantyre coma scores, temperature and parasitaemia were monitored.
Mortality and neurological deficits were documented. There was no differenc
e in mortality rates (chloroquine, 16.7 per cent; artesunate, 21.7 per cent
;p = 0.6), neurological deficit at day 14 (chloroquine, 0 per cent; artesun
ate, 4.3 per cent; p = 0.3), resolution of fever (p = 0.55), and coma recov
ery time (p = 0.8), between the two groups. The results suggest that syrup
chloroquine and intramuscular/oral artesunate currently give comparable cli
nical responses in the treatment of cerebral malaria in Ghana, Possible rea
sons for this are discussed, and suggestions are made for future antimalari
al drug policy.