Skip to main content
. 2019 Jun 18;2019(6):CD010678. doi: 10.1002/14651858.CD010678.pub3

Karbwang 1995.

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 non‐pregnant female patients with severe P falciparum malaria (WHO definition) with no history of antimalarial treatment within 24 hours before admission aged 15 to 65 years and weighing 45 to 75 kg
Exclusion criteria: patients with concurrent diseases were excluded
Interventions
  • Intramuscular artemether

    • Loading dose of 160 mg...

    • ...followed by 80 mg once daily for 6 days.

  • Intravenous quinine

    • Loading dose of 20 mg/kg...

    • ...followed by 10 mg/kg 8‐hourly for 7 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 might not have been 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.