Effect of iron chelation therapy on mortality in Zambian children with cerebral malaria. 1998

P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
Pennsylvania State University, Hershey Medical Center, USA.

To examine the effect of iron chelation on mortality in cerebral malaria, we enrolled 352 children in a trial of deferoxamine in addition to standard quinine therapy at 2 centres in Zambia, one rural and one urban. Entrance criteria included age < 6 years, Plasmodium falciparum parasitaemia, normal cerebral spinal fluid, and unrousable coma. Deferoxamine (100 mg/kg/d infused for a total of 72 h) or placebo was added to a 7 d regimen of quinine that included a loading dose. Mortality overall was 18.3% (32/175) in the deferoxamine group and 10.7% (19/177) in the placebo group (adjusted odds ratio 1.8; 95% confidence interval 0.9-3.6; P = 0.074). At the rural study site, mortality was 15.4% (18/117) with deferoxamine compared to 12.7% (15/118) with placebo (P = 0.78, adjusted for covariates). At the urban site, mortality was 24.1% (14/58) with deferoxamine and 6.8% (4/59) with placebo (P = 0.061, adjusted for covariates). Among survivors, there was a non-significant trend to faster recovery from coma in the deferoxamine group (adjusted odds ratio 1.2; 95% confidence interval 0.97-1.6; P = 0.089). Hepatomegaly was significantly associated with higher mortality, while splenomegaly was associated with lower mortality. This study did not provide evidence for a beneficial effect on mortality in children with cerebral malaria when deferoxamine was added to quinine, given in a regimen that included a loading dose.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007502 Iron Chelating Agents Organic chemicals that form two or more coordination links with an iron ion. Once coordination has occurred, the complex formed is called a chelate. The iron-binding porphyrin group of hemoglobin is an example of a metal chelate found in biological systems. Iron Chelates,Agents, Iron Chelating,Chelates, Iron,Chelating Agents, Iron
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011803 Quinine An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. Biquinate,Legatrim,Myoquin,Quinamm,Quinbisan,Quinbisul,Quindan,Quinimax,Quinine Bisulfate,Quinine Hydrochloride,Quinine Lafran,Quinine Sulfate,Quinine Sulphate,Quinine-Odan,Quinoctal,Quinson,Quinsul,Strema,Surquina,Bisulfate, Quinine,Hydrochloride, Quinine,Sulfate, Quinine,Sulphate, Quinine
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D003676 Deferoxamine Natural product isolated from Streptomyces pilosus. It forms iron complexes and is used as a chelating agent, particularly in the mesylate form. Desferrioxamine,Deferoxamine B,Deferoxamine Mesilate,Deferoxamine Mesylate,Deferoxamine Methanesulfonate,Deferoximine,Deferrioxamine B,Desferal,Desferioximine,Desferrioxamine B,Desferrioxamine B Mesylate,Desferroxamine,Mesilate, Deferoxamine,Mesylate, Deferoxamine,Mesylate, Desferrioxamine B,Methanesulfonate, Deferoxamine
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked

Related Publications

P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
November 1992, The New England journal of medicine,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
March 1991, Journal of tropical pediatrics,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
January 1994, Advances in experimental medicine and biology,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
January 1999, Pharmacology & therapeutics,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
February 1996, The American journal of tropical medicine and hygiene,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
February 1981, East African medical journal,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
October 1989, Annales de pediatrie,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
March 2005, Current hematology reports,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
March 1995, Current opinion in hematology,
P E Thuma, and G F Mabeza, and G Biemba, and G J Bhat, and C E McLaren, and V M Moyo, and S Zulu, and H Khumalo, and P Mabeza, and A M'Hango, and D Parry, and A A Poltera, and G M Brittenham, and V R Gordeuk
May 2023, European journal of haematology,
Copied contents to your clipboard!