Rectal artemisinins rapidly eliminate malarial parasites

Mar 28, 2008

Artemisinin-based suppositories can help ‘buy time’ for malaria patients who face a delay in accessing effective, injectable antimalarials, according to research published in the online open access journal BMC Infectious Diseases.

Plasmodium falciparum malaria can progress to severe disease and death in a number of hours, so prompt treatment is crucial. As such, rectal artemisinins can be used as emergency treatment, particularly in rural areas with limited access to injectable antimalarial therapy and suitably trained staff.

Derived from sweet wormwood, artemisinin has been used in traditional Chinese medicine for thousands of years. In the 1990s, researchers recognised its antimalarial activity and since then a number of safe and effective artemisinin derivatives have been developed. These drugs, given by mouth, as a rectal suppository or injected into a vein or muscle have been shown to rapidly reduce heavy parasite infection. Oral artemisinin-based combination treatments now form the basis of antimalarial treatment policies in most malaria endemic countries.

Suppositories are easy to administer and the World Health Organization Malaria Treatment Guidelines currently recommends rectal artemisinins as a pre-referral treatment for severe malaria. However, more information is needed about the comparative efficacy of the different artemisinin derivatives. Researchers pooled the individual patient data of over 1000 patients from 15 clinical trials of rectal artemisinins – artemisinin, artesunate and artemether – to compare the efficacy of these drugs with each other and conventional injectable antimalarials such as quinine.

In the 24 hours after treatment, rectal artemisinins – artemisinin, artesunate, and artemether - cleared malarial parasites in the blood more rapidly than quinine injection. A higher single dose of rectal artesunate to initiate treatment was five times more likely to reduce the number of parasites by over 90% than multiple lower doses of artesunate – suggesting that immediate rapid achievement of high drug concentration in severe malaria might be key to effectively killing parasites. This analysis did not look at whether the early use of rectal artemisinins saves lives, but it is hoped that their ability to rapidly kill large numbers of parasites might make a real difference to survival.

The authors write: “Early effective treatment with artemisinin-based suppositories has potential as a lifesaving intervention, particularly at the periphery of the health-care system, where suppositories might be administered early in lieu of parenteral treatment in remote communities by relatively untrained personnel. Combined with accurate diagnosis and artemisinin-based combination therapy, rectal artemisinins have been effectively used to reduce malaria incidence and mortality in Asia, an approach which holds great promise for malaria control elsewhere.”

Source: BioMed Central

Explore further: Experimental Ebola drug heals all monkeys in study (Update)

add to favorites email to friend print save as pdf

Related Stories

FIXD tells car drivers via smartphone what is wrong

11 hours ago

A key source of anxiety while driving solo, when even a bothersome back-seat driver's comments would have made you listen: the "check engine" light is on but you do not feel, smell or see anything wrong. ...

Team pioneers strategy for creating new materials

12 hours ago

Making something new is never easy. Scientists constantly theorize about new materials, but when the material is manufactured it doesn't always work as expected. To create a new strategy for designing materials, ...

Shell files new plan to drill in Arctic

12 hours ago

Royal Dutch Shell has submitted a new plan for drilling in the Arctic offshore Alaska, more than one year after halting its program following several embarrassing mishaps.

Aging Africa

12 hours ago

In the September issue of GSA Today, Paul Bierman of the University of Vermont–Burlington and colleagues present a cosmogenic view of erosion, relief generation, and the age of faulting in southernmost Africa ...

Recommended for you

Ebola in mind, US colleges screen some students

17 hours ago

University students from West Africa may be subject to extra health checks when they arrive to study in the United States as administrators try to insulate their campuses from the worst Ebola outbreak in ...

WHO: More Ebola cases in past week than any other

18 hours ago

The past week has seen the highest increase of Ebola cases since the outbreak in West Africa began, the World Health Organization said Friday, offering more evidence that the crisis is worsening.

User comments : 0