DOI: 10.36347/sajp

Pages: 27-33

Severe falciparum malaria is a common and fatal malarial illness. The recommended regimen for severe falciparum malaria includes either artesunate or quinine based treatment. 100 patients of severe falciparum malaria were divided into two groups and randomly assigned to either ARTESUNATE or QUININE based regimen. A detailed clinical and biochemical evaluation of both groups was compared. Most common clinical signs were pallor, icterus, hepatosplenomegaly, altered sensorium and decreased urine output. 30% of patients had GCS <11, 87% had serum lactate >5mmol/L, S. Bilirubin was raised in 50% but abnormal AST/ALT was found in all patients and equally distributed in both groups. Of the two regimens hypoglycemia during treatment was more common in QUININE group than ARTESUNATE group (30% vs 12%), there was also increased mortality in quinine group (13 vs 7) but was not statistically significant. However, mean hemoglobin rise, normalization of GCS, LFT, time to death and coma recovery time were no different in two groups. Among the quinine treated patients there was an increased incidence of hearing disturbances (24%), QT interval prolongation (6%), ARF (4%) and visual disturbance was present in one patient.