In vivo efficacy of quinine treatment for Plasmodium falciparum malaria in Malawian children

Twenty-five Malwaian children with Plasmodium falciparum infection were studied for response to quinine in an eight-hourly dosage of 10 mg salt kg-1 body weight. The mean parasite clearance time, defined as the time after initiation of treatment when the first of two consecutive 12-hourly smears was negative for P. falciparum parasites, was 67 hours. The mean fever clearance time, defined as the time after initiation of treatment when the axillary temperature first fell below 37.5 degrees C and remained below this level for 48 hours, was 36 hours. Twenty-four hours after the first dose of quinine, the geometric mean parasite density among the children studied had decreased by 84%, from 41 357-6586 parasites mm-3, and all children cleared their parasitaemia within 108 hours. Results of this study confirm that quinine remains effective in rapidly controlling P. falciparum parasitaemias in Malawi, where resistance to the 4-aminoquinolines is highly prevalent.