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Guidelines for the treatment of malaria – 2 edition

ANNEX 8
treatment of severe PlasmODium falciParum
malaria

The GRADE tables in this section are based on the Cochrane review titled “Artesunate
versus quinine for treating severe malaria” published in 2007 (1). A brief outline of the
methodology of this review is given below.

Objective
The goal is to compare artesunate with quinine for treating severe malaria.

inclusion criteria
Randomized controlled trials comparing artesunate with quinine in adults and children
with severe malaria who are unable to take medication by mouth.

search methods
A search was conducted in December 2008 of The Cochrane Infectious Disease Group
Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL),
MEDLINE, EMBASE, LILACS, ISI Web of Science and the metaRegister of Controlled
Trials (mRCT) using “artesunate” and “quinine” as search terms. Conference proceedings
were hand searched.

Data collection and analysis

Two authors independently assessed trials for eligibility, risk of bias and extracted data.
Outcomes included death, neurological sequelae, coma recovery time, time to hospital
discharge, fever clearance time and parasite clearance time, serious adverse effects,
hypoglycaemia and other adverse effects. Drugs were compared using risk ratios for
dichotomous data, weighted mean difference for continuous data and 95% confidence
intervals.

results

Six trials enrolling 1938 participants met the inclusion criteria. The results are presented
below.

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