New malaria drug can save millions of lives: Study

By Dr. Ananya Mandal, MDNov 8 2010

A landmark trial showed that the replacement of the standard malaria drug Quinine with the newer drug Artesunate for children with severe malaria could save 100,000 lives a year. The World Health Organisation (WHO) recommended that artesunate derived from a Chinese plant called sweet wormwood, replace the four-century-old remedy of quinine for treating severe malaria in adults in 2006. Similar recommendations were not made for children with further trial results pending.

Now the trial results are published online by The Lancet and it shows that using artesunate reduced death from severe falciparum malaria among African children by 22.5 per cent compared to quinine. The trial spanned over nine African countries, in which 5,425 badly-infected children aged under 15 were given either artesunate or quinine. There were 230 deaths (8.5 percent) in the artesunate group and 297 deaths (11 percent) in the quinine group, the study authors reported. Artesunate was better tolerated than quinine. There was a lower risk of coma or convulsion or serious dropping of blood sugar as occurred with quinine.

Study leader Nicholas White, a professor at Mahidol University in Bangkok said, “Artesunate should now become the treatment of choice for severe malaria for children and adults worldwide.” Malaria causes an estimated 800,000 deaths every year in African children. Severe malaria is often the most common admission diagnosis in febrile children, so a change in treatment policy from quinine to artesunate has the potential to save thousands of children’s lives every year, the study says.

The study adds, “If four million African children with severe malaria every year were to receive prompt treatment with parenteral artesunate instead of quinine, and the benefits were similar to those recorded in this trial, then approximately 100,000 lives might be saved per year.”

Artesunate contains artemisinin, which was discovered by a Chinese researcher in 1972 in a project to follow up advice found in ancient Chinese medicine. The concerns with the drug’s use include cost, availability and counterfeiting.

The trial known as the AQUAMAT trial was inspired by the results of a trial among malaria-infected adults in Southeast Asia, which led to the new WHO guidelines in 2006.

The study results were presented at a meeting of the American Society for Tropical Medicine and Hygiene, held in Atlanta.