The CARAMAL study could not assess the effectiveness of rectal artesunate in treating suspected severe malaria.
BMC Med
; 21(1): 118, 2023 03 30.
Article
in English
| MEDLINE | ID: covidwho-2305572
ABSTRACT
CARAMAL was a large observational study which recorded mortality in children with suspected severe malaria before and after the roll-out of rectal artesunate in Nigeria, Uganda and the Democratic Republic of the Congo. The results of CARAMAL have had a huge impact on public health policy leading to a World Health Organization moratorium on the roll-out of rectal artesunate. The conclusion reported in the abstract uses strong causal language, stating that "pre-referral RAS [rectal artesunate suppositories] had no beneficial effect on child survival". We argue that this causal interpretation of the study results is not justified. Data from the CARAMAL study inform chiefly on the strengths and weaknesses of referral systems in these three countries and do not inform reliably as to the beneficial effect of providing access to a known life-saving treatment.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Artemisinins
/
Malaria
/
Antimalarials
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Child
/
Child, preschool
/
Humans
Language:
English
Journal:
BMC Med
Journal subject:
Medicine
Year:
2023
Document Type:
Article
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