Table 1 Summary of studies of quinine for the treatment of uncomplicated malaria
From: Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria
| Study site | Year | Sample size and study population | Drug Regimens | Duration of follow-up | Treatment outcome | Comment | Reference |
|---|---|---|---|---|---|---|---|
| Thailand, region with multidrug resistant malaria | 1984-1985 |
66 children 2-12 years | Quinine Quinidine |
28 days DOT |
Cure rates: Quinine - 85% Quinidine - 88% | Treatment failures only RI responses | [29] |
| Cambodia, region with multidrug resistant malaria | 1983 |
119 adults, >15 years |
Mefloquine +SP (MSP) 3 days quinine+tetracycline (Q3T7) 7 days of quinine+ tetracycline (Q7T7) |
28 days DOT |
Cure rates: MSP: 98% Q3T7: 76% Q7T7: 92% | Q7T7 still gives good cure rate | [30] |
| Brazil, setting with quinine resistance | 1985 |
100 patients 18-55 years |
Mefloquine 1000 mg single dose (MQ) 3 days quinine+SP (Q3+SP) |
42 days DOT |
Cure rates: MQ: 96% Q3 + SP: 98% | Four RI responses in Q3 + SP group | [31] |
| Thailand, region with multidrug resistant malaria | 1994 |
102 patients 16-60 years |
Mefloquine+tetracycline (MQT) 7 days of Quinine+ tetracycline (Q7T7) |
28 days DOT |
Cure rates: MQT: 94% Q7T7: 98% | MQ + Tetra as effective as Q7T7 | [34] |
| Thailand, region with multidrug resistant malaria | 1995-1997 |
204 male patients 15-64 years |
7 days quinine (Q7) Quinine + tetracycline (Q7T7) Quinine + clindamycin (Q7C7) |
28 days Directly observed therapy |
Cure rates: Q7: 87% Q7T7: 98% Q7C7: 100% | Tetracycline or clindamycin improves quinine cure rates | [33] |
| Equatorial Guinea, setting with no quinine resistance | 1999 |
114 children 6-59 months |
7days quinine (Q7) Chloroquine (CQ) Sulfadoxine/pyrimethamine (SP) | 114 day follow-up |
Cure rates: Q7: 94.5% CQ: 60% SP: 90% | Quinine is effective against P.falciparum malaria | [43] |
| Cameroon, High transmission setting | 2005 |
30 children 0.5-6 years | 5 days quinine (Q5) | 14 day follow-up | Cure rates: 100% | [41] | |
| Burundi Perennial transmission setting | 1992-1995 |
472 children 0-14 years |
Chloroquine (CQ) 5 days quinine (Q5) | 7 day follow-up |
Failure rates Q5: 1992-1993: 4.2% 1994-1995: 7.1% | [40] | |
| Guinea-Bissau Perennial transmission setting | 1994-1995 |
203 children 0.7-13 years |
3 days quinine (Q3) 5 days quinine (Q5) 7 days quinine (Q7) | 28-35 day follow-up |
Day 28 recurrent parasitemia: Q3: 79% Q5: 90% Q7: 11% | 3 day quinine regimens should not be used. | [37] |
| Gabon High transmission setting | 1993-1994 | 120 adults = 15years |
3 days quinine (Q3) 3 days quinine+clindamycin (Q3C3) 3 days quinine+doxycycline (Q3D3) | 28 day follow-up |
Day 28 cure rates: Q3: 38% Q3C3: 92% Q3D3: 91% | The two short course combinations of quinine had excellent cure rates | [109] |
| Uganda Meso-endemic transmission setting | 2007-2008 |
175 children 6months - 5 years |
7 days quinine (Q7) 3 days artemether-lumefantrine (AL) | 28 day follow-up |
Cure rates: Q7: 64% AL: 97% | Results question the advisability of quinine use for uncomplicated malaria | [45] |