Efficacy of artemether in severe falciparum malaria in African children.

The clinical efficacy of intramuscular artemether was studied in 144 children suffering from severe non cerebral malaria. Fifty-three children with chloroquine-resistant and 27 children with sulfadoxinepyrimethamine-resistant falciparum malaria were also studied. Greater than 95% of pre-treatment parasitaemia was cleared by 24 h after commencement of treatment in all groups. The parasite and fever clearance times were 35.4 +/- 8.0 and 18.6 +/- 6.3 h respectively, in children suffering from severe non cerebral malaria 36.3 +/- 7.9 and 15.6 +/- 3.8 h, respectively, in the chloroquine-resistant and 36.8 +/- 8.8 and 16.5 +/- 4.2 h, respectively, in the sulfadoxine-pyrimethamine-resistant groups. The cure rate in all groups on day 14 was 100%. Side effects following treatment were minimal and comprised pain with mild tenderness at site of injection in two children and bradycardia, on the second or third day of treatment, in another two patients. No patient had pruritus. These data suggest that artemether is rapidly effective in falciparum malaria in children irrespective of previous drug treatment and especially in chloroquine- or sulphadoxinepyrimethamine-resistant infection and in this study was without deleterious side effects.