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The efficacy of quinine plus clindamycin was compared with that of artemether-lumefantrine in the treatment of uncomplicated <jats:italic>Plasmodium falciparum<\/jats:italic> malaria in children below 5\u00a0years of age.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>An open-label, phase 3, randomized trial was conducted in western Kenya. Children aged 6\u201359\u00a0months with uncomplicated falciparum malaria were randomly assigned (1:1) via a computer-generated randomization list to receive 3\u00a0days of twice a day treatment with either oral quinine (20\u00a0mg\/kg\/day) plus clindamycin (20\u00a0mg\/kg\/day) or artemether-lumefantrine (artemether 20\u00a0mg, lumefantrine 120\u00a0mg) as one (for those weighing 5\u201314\u00a0kg) or two (for those weighing 15\u201324\u00a0kg) tablets per dose. The primary outcome was a PCR-corrected rate of adequate clinical and parasitological response (ACPR) on day 28 in the per-protocol population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 384 children enrolled, 182\/192 (94.8%) receiving quinine plus clindamycin and 171\/192 (89.1%) receiving artemether-lumefantrine completed the study. The PCR-corrected ACPR rate was 44.0% (80 children) in the quinine plus clindamycin group and 97.1% (166 children) in the artemether-lumefantrine group (treatment difference \u2212\u00a053.1%, 95% CI \u2212\u00a043.5% to \u2212\u00a062.7%). At 72\u00a0h after starting treatment, 50.3% (94 children) in the quinine plus clindamycin group were still parasitaemic compared with 0.5% (1 child) in the artemether-lumefantrine group. Three cases of severe malaria were recorded as serious adverse events in the quinine plus clindamycin group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The study found no evidence to support the use of a 3-day low dose course of quinine plus clindamycin in the treatment of uncomplicated falciparum malaria in children under 5\u00a0years of age in Kenya, where artemether-lumefantrine is still effective.<\/jats:p>\n                <jats:p><jats:italic>Trial Registration<\/jats:italic>: This trial is registered with the Pan-African Clinical Trials Registry, PACTR20129000419241.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-022-04050-8","type":"journal-article","created":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T10:02:59Z","timestamp":1643796179000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of 3-day low dose quinine plus clindamycin versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Kenyan children (CLINDAQUINE): an open-label randomized trial"],"prefix":"10.1186","volume":"21","clinical-trial-number":[{"clinical-trial-number":"pactr20129000419241","registry":"10.18810\/pactr"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0741-8533","authenticated-orcid":false,"given":"Charles O.","family":"Obonyo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Juma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent O.","family":"Were","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhards R.","family":"Ogutu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,2]]},"reference":[{"key":"4050_CR1","unstructured":"WHO. 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The trial was conducted according to the Declaration of Helsinki and guidelines on Good Clinical Practice. All primary caregivers provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30"}}