Mannitol and other osmotic diuretics as adjuncts for treating cerebral malaria

Abstract

BACKGROUND: The main treatment for cerebral malaria is parenteral antimalarials. Mannitol and urea are used as adjunct therapy for cerebral malaria, but the World Health Organization does not recommend them. OBJECTIVES: To compare mannitol or urea to placebo or no treatment for treating children and adults with cerebral malaria. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group Specialized Register (June 2004), CENTRAL (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to June 2004), EMBASE (1974 to June 2004), LILACS (1982 to June 2004), and reference lists of articles. We contacted relevant organizations and researchers. SELECTION CRITERIA: Randomized and quasi-randomized controlled trials comparing mannitol or urea to placebo or no treatment in children and adults with cerebral malaria. DATA COLLECTION AND ANALYSIS: No trials met the inclusion criteria. MAIN RESULTS: No trials met the inclusion criteria. REVIEWERS' CONCLUSIONS: We identified no randomized or quasi-randomized controlled trials to support or refute the use of mannitol or urea as adjuncts for treating cerebral malaria in clinical practice. This is likely to require a multicentre trial.