Muhammad Bilal, Yaseen Khan, Awais Naeem.
Effectiveness of Intravenous Artesunate in the Treatment of Cerebral Malaria Due to Falciparum Malaria.
Ann Pak Inst Med Sci Jan ;10(2):71-4.

Objective: To determine the effectiveness of intra venous artesunate in the treatment of cerebral malaria due to falciparum malaria. Study design: Prospective observational study Place and Duration: The study was conducted in the department of Medicine from January 2013 to December 2013 Material and Methods: A total of 137 patients with cerebral malaria were included in the study. Diagnosis based on clinical findings as well as thick smear study of the patients. Only smear reported as falciparum malaria positive from the hospital laboratory with clinical correlation for cerebral malaria findings were included in the study. Patients with signs of meningeal irritation or any previous history of flue like illness followed by abnormal behaviors were excluded from the study. The patients were given intravenous artesunate in optimum dose of 2.4mg/kg every 12hr for 1day, then daily for 3days. Patients were shifted to oral doxycycline after completion of 4days of IV artesunate treatment at dose of 100mg bd for 5days. Patients were monitored closely round the clock and finally after 3days of optimum treatment of artesunate effectiveness were determined in terms of survival from cerebral malaria with improvement in encephalopathy. Results: In this study, out of 137 patients 54(39.42%) were female and 83(60.58%) were male. The patients were from 11 to 60 years of age. Average age was 38.69 years + 13.91SD. Efficacy of artesunate among patients presenting with cerebral malaria due to falciparum malaria was found in 105(76.64%). Age wise distribution of efficacy shows that majority of the efficacy was in 36-50 years of age. i.e 81%, age of less than20 years have 57.1% patients, patients have age 21-35 years shows 80.9% and age more than 50 years of age have very low efficacy 73.5%. Efficacy in males was 67(80.7%) while in female 38(70.4%). Conclusion: Findings proved that intravenous artesunate is effective in the treatment of cerebral malaria in adults.

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