Pentoxifylline as an adjunct therapy in children with cerebral malaria

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Bertrand Lell1, Carsten Köhler, Betty Wamola

  • 1KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya. bertrand.lell@uni-tuebingen.de

Malaria Journal
|December 24, 2010
PubMed

Insights

Pentoxifylline (PTX) did not significantly alter mortality in African children with cerebral malaria. While TNF levels were lower in the PTX group, the study noted unexpectedly high mortality rates.

Area of Science:

  • Pediatric infectious diseases
  • Pharmacology and pharmacokinetics
  • Malariology

Background:

  • Severe malaria, particularly cerebral malaria, poses a significant threat to children in endemic regions.
  • Pentoxifylline (PTX) has demonstrated potential in modulating disease processes relevant to malaria pathogenesis.
  • Previous research indicated PTX could shorten coma duration in pediatric cerebral malaria.

Purpose of the Study:

  • To evaluate the pharmacokinetics, safety, and efficacy of Pentoxifylline (PTX) in African children diagnosed with cerebral malaria.
  • To assess the impact of PTX on clinical outcomes and biological markers in this patient population.

Main Methods:

  • A pilot study involving ten children with cerebral malaria receiving quinine plus a continuous infusion of PTX (10 mg/kg/24 hours for 72 hours).
  • A control group of five children received quinine with normal saline.
  • Measurements included plasma PTX and tumor necrosis factor (TNF) levels, Blantyre Coma Score, parasitemia, hematology, and vital signs.

Main Results:

  • Mortality was 40% in the PTX group versus 20% in the control group, a difference that was not statistically significant (p = 0.60).
  • Laboratory parameters and clinical data showed no significant differences between the groups.
  • Children treated with PTX exhibited lower levels of tumor necrosis factor (TNF).

Conclusions:

  • The study's small sample size precludes definitive conclusions regarding PTX efficacy.
  • An unexpectedly high mortality rate was observed in the Pentoxifylline (PTX) treatment group.
  • Further investigation with larger cohorts is warranted to ascertain the safety and efficacy of PTX in pediatric cerebral malaria.
Abstract

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