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.