Karbwang 1995 THA

Methods	Trial design: RCT Trial dates:1992 to 1994
Participants	Number of participants: 102 adults aged between 15 and 55 years enrolled Inclusion criteria: Male and female (non‐pregnant) patients with severe falciparum malaria (WHO definition) with no history of antimalarial treatment within 24 hours before admission aged 15 to 65 years and weighing 45 to 75kg Exclusion criteria: Patients with concurrent diseases were excluded
Interventions	1. Intramuscular artemether Loading dose of 160 mg Followed by 80 mg once daily for six days 2. Intravenous quinine Loading dose of 20 mg/kg Followed by 10 mg/kg eight hourly for seven days Followed by quinine sulphate tablets as soon as oral medication was possible
Outcomes	Outcomes included in the review: Death Coma resolution time Neurological sequelae Fever clearance time Parasite clearance time Adverse effects Outcomes not included in the review: Survival rate
Notes	Location: Prapokklao Hospital, Chantaburi, Thailand Transmission: Not stated Funding: UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Central randomization at WHO Office.
Allocation concealment (selection bias)	Low risk	"Each treatment was enclosed in a sealed envelope, which was opened only after the physician in charge had decided to recruit the patient into the study".
Blinding (performance bias and detection bias) Objective outcome: Death	Low risk	Trial authors provided no information on blinding. However, lack of blinding is unlikely to bias an objective outcome like death.
Blinding (performance bias and detection bias) Subjective outcomes: Others	High risk	Trial authors provided no information on blinding, however it may not be feasible due to different routes of administration for both interventions.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Loss to follow‐up about 5%.
Selective reporting (reporting bias)	Low risk	No evidence of selective reporting.
Other bias	Low risk	No other bias identified.