Rectal Drug Helps Control Malaria Quickly

A rectal dose of artesunate, an antimalaria drug usually given by mouth, rapidly reduces blood levels of the parasite in patients with severe disease, according to research in The Lancet. The effect is only temporary, however, and its primary value lies in reducing symptoms until curative treatment can take place.

A rectal dose of artesunate, an antimalaria drug usually given by mouth, rapidly reduces blood levels of the parasite in patients with severe disease, according to research in The Lancet. The effect is only temporary, however, and its primary value lies in reducing symptoms until curative treatment can take place. Delay in effective treatment in patients unable to take pills is a primary reason for high death rates, senior author Dr. Malcolm E. Molyneux, at the University of Liverpool, UK, and colleagues note. “Rectal artesunate has the potential to reduce malaria-related” problems and death, they add. The team enrolled 109 children in Malawi and 35 adults in South Africa with moderately severe malaria who were not at immediate risk of death. Eight-seven children and 27 adults were randomly assigned to a single dose of rectal artesunate, while 22 children and 8 adults where assigned to three doses of intravenous quinine, another drug commonly used to treat malaria. Treatment with artesunate produced a more rapid decline in parasite levels than quinine did. By 24 hours, all of the patients were able to take anti-malaria pills and all made a full recovery. Molyneux and his colleagues found that parasite levels rose soon after rectal treatment with artesunate, reinforcing the need to complete effective treatment as soon as possible. “Health-care providers need to ensure that patients or caregivers understand the need for further curative treatment at a referral center,” they write. (Source: Reuters Health, The Lancet, May 2004)