A Cochrane review included 8 studies with a total of 7 429 subjects (1 664 adults and 5 765 children). Six trials were conducted in Asia and two in Africa. All trials compared artesunate with quinine, but the exact dosing and route of administration varied between trials. Treatment with artesunate significantly reduced the risk of death both in adults (RR 0.61, 95% CI 0.50 to 0.75; 5 studies, n=1 664) and children (RR 0.76, 95% CI 0.65 to 0.90; 4 studies, n=5 765). In children, treatment with artesunate increased the incidence of neurological sequelae at the time of hospital discharge. The majority of these sequelae were transient and no significant difference between treatments was seen at later follow up.