[Evaluation of the treatment of malaria using a 3-day regimen of quinine in Dakar].

The efficacy of quinine treatment for Plasmodium falciparum strains remains sound. However reports of decreased sensitivity and resistance of some strains in Asia and East Africa indicate that current treatment regimens should be re-adjusted. The purpose for the present study carried out in Dakar, Senegal, was to evaluate the local regimen for acute Plasmodium falciparum malaria using quinine at a dose of 20 mg/kg per day in two daily injections on 3 consecutive days. Thirty-seven patients with acute Plasmodium falciparum malaria including 10 severe cases were treated using the standard regimen and followed up clinically and parasitologically from Day 0 to Day 7. On Day 7 parasites were still detectable in the blood of four patients for a failure rate of 10.8%. Persistence of parasites despite disappearance of clinical symptoms suggests that the regimen should be increased to 25 mg/kg per day for at least for 3 days or longer if symptoms persist. Due to its adverse effects and cost (10 times higher than chloroquine treatment), quinine treatment should be prescribed only for patients with severe malaria forms.