Pentoxifylline as an adjunct therapy in children with cerebral malaria

Malaria Journal

Research

Terrie E Taylor¹  David Wypij²  Carsten Köhler³  Betty Wamola⁴  Esther Kivaya⁴  Christopher HO Olola⁴  Sadik Mithwani⁴  Gilbert Kokwaro⁵  Charles RJC Newton⁶  Bertrand Lell⁷  Peter G Kremsner⁸ 

[1] College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA;Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi;Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA;Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA;Department of Cardiology, Children's Hospital Boston, Massachusetts, USA;Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany;KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya;KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya;Department of Pharmaceutics & Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya;KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya;Institute of Child Health, University College London, London, UK;London School of Hygiene and Tropical Medicine, London, UK;KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya;Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon;Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany;Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon;Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany;

关键词: Malaria;    Severe Malaria;    Pentoxifylline;    Cerebral Malaria;    Aspartate Transaminase;   

DOI  :  10.1186/1475-2875-9-368

 received in 2010-07-23, accepted in 2010-12-21,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundPentoxifylline (PTX) affects many processes that may contribute to the pathogenesis of severe malaria and it has been shown to reduce the duration of coma in children with cerebral malaria. This pilot study was performed to assess pharmacokinetics, safety and efficacy of PTX in African children with cerebral malaria.MethodsTen children admitted to the high dependency unit of the Kilifi District Hospital in Kenya with cerebral malaria (Blantyre coma score of 2 or less) received quinine plus a continuous infusion of 10 mg/kg/24 hours PTX for 72 hours. Five children were recruited as controls and received normal saline instead of PTX. Plasma samples were taken for PTX and tumour necrosis factor (TNF) levels. Blantyre Coma Score, parasitemia, hematology and vital signs were assessed 4 hourly.ResultsOne child (20%) in the control group died, compared to four children (40%) in the PTX group. This difference was not significant (p = 0.60). Laboratory parameters and clinical data were comparable between groups. TNF levels were lower in children receiving PTX.ConclusionsThe small sample size does not permit definitive conclusions, but the mortality rate was unexpectedly high in the PTX group.

【 授权许可】

CC BY   
© Lell et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.