A randomized comparison of intramuscular artemether and intravenous quinine in children with
severe malaria is conducted. Patients were randomized to receive either quinine or artemether. That is, one
patient with specific clinical presentation of severe malaria was given intravenous quinine after consent from
parents and another patient with similar clinical presentation of severe malaria was treated with artemether.
Comparison of two drugs to determine the efficacy was done by certain criteria like, clearance of parasites and
fever, recovery from coma and normal functions of the involved system. Sixty cases completed the study
protocol, 30 assigned to each drug group. Cerebral malaria was the commonest manifestation (41%). Mean ages
in artemether versus quinine group (6.6±3.5 and 5.8±2.4 years) were comparable. The overall mortality rate was
25% with little difference between the two groups. Twelve cases (20%) presented with more than one
manifestations of severe malaria. The mortality rate was more with coexisting manifestations of severe malaria.
Fever clearance time in artemether and quinine group was 38.5 and 45.5 h, respectively (p>0.05). Parasite
clearance time was significantly shorter in artemether group (40.9 vs. 51.9 h; p<0.001). Recovery from coma was
shorter in artemether group (34.8 vs. 38.1 h; p<0.05). The results obtain support the hypothesisi that Artemether
is a good alternative drug to quinine. Mortality rate is directly proportional to the number of coexisting
manifestations of severe malaria.