Artemether in moderately severe and cerebral malaria in Nigerian children

Intramuscular artemether was compared with intramuscular sulfadoxine-pyrimethamine in Nigerian children with moderately severe malaria requiring parenteral therapy. Artemether produced significantly shorter parasite and fever clearance times but a higher parasite recrudescence rate than sulfadoxine-pyrimethamine. There was no significant difference in their initial parasitological cure rates--100% for artemether, 98% for sulfadoxine-pyrimethamine. In a separate study intramuscular artemether was compared with intravenous quinine in children with cerebral malaria. There was no significant difference between the 2 drugs in parasite and fever clearance times, time to regain consciousness, or recrudescence rate. There was an overall mortality of 16.7%, with 12% in the artemether group and 21% in the quinine group. Artemether was well tolerated. There was no abnormal change in haematological and biochemical features monitored and there was no adverse clinical reaction. These results show that artemether is a potentially useful drug for moderate and severe malaria and its place in the chemotherapy of malaria deserves further study.