A randomised phase 2a trial of safety, efficacy, pharmacokinetics and pharmacodynamics of L-Arginine in severe falciparum malaria

This study is testing whether a supplement called L-arginine, given by drip alongside standard anti-malaria treatment, can help reduce deaths and severe complications from falciparum malaria. Severe malaria is a life-threatening condition, and even with the best available treatment about 15% of patients die. L-arginine may help by improving blood vessel function and increasing nitric oxide levels. Participants will receive IV L-arginine or a placebo in addition to their standard malaria treatment. You may be eligible if: - You are between 16 and 60 years old - You have confirmed P. falciparum malaria with one or more signs of severity (such as kidney failure, altered consciousness, high parasite counts, or abnormal blood tests) - You have recently started parenteral anti-malaria treatment (artesunate or quinine) You may NOT be eligible if: - You are pregnant or breastfeeding - You have diabetes - You have serious pre-existing heart, liver, or kidney disease - Your blood pressure is very low even after fluids - Certain blood test values are outside safe ranges (such as very low bicarbonate or very high potassium) - You have a known allergy to L-arginine - You are taking certain medications including spironolactone, nitrates, sildenafil, alpha-blockers, or L-arginine Talk to your doctor about whether this trial might be right for you.