Intramuscular artemether versus intravenous quinine in treatment of cerebral malaria in pediatric patients

Background: Cerebral malaria is one of the complications of malaria and carries high mortality if not treated timely and promptly. The current study was conducted in this regard to compare the role of intramuscular artemether with intravenous quinine in treatment of children with cerebral malaria.Material Methods: This was a hospital based randomized controlled trial conducted at the Pediatric unit A Department of Child Health, Khyber Teaching Hospital, Peshawar from May 2003 to April 2004. A total of 50 patients fulfilling of cerebral malaria were enrolled in the study. Each 25 patients were assigned randomly to receive either intravenous quinine or intramuscular artemether and response was documented. The results were compared with national and international studies.Results: Majority of patients presented with altered consciousness (100%) and fever (96%). Out of 25 patients treated with Artemether, 22 (88%) recovered completely and three patients (12%) died. While in Quinine group 21 (84%) recovered completely and four (16%) died. No residual sequalae were detected in either group. Rate of resolution of coma, Parasitemia and fever was almost same in both groups. Deep coma and multi organ system involvement had poor prognosis. In quinine group hypoglycemia during treatment was observed in four patients (16%).Conclusion: Artemether is as effective as quinine in the treatment of cerebral malaria