Rosiglitazone Adjunctive Therapy for Severe Malaria in Children

Inclusion Criteria: * Age 1-12 years * Positive 3-band (HRPII plus pLDH) P. falciparum rapid diagnostic test (RDT) and microscopy confirmed malaria infection with parasitemia \>2500 parasites/microlitre if microscopy is available in a timely manner at the time of randomization. * One or more features of severe malaria: repeated seizures (two or more generalized seizures in 24 h); prostration (in children 1 year and older, the child is unable to sit unsupported or stand although was able to before the illness); impaired consciousness (Blantyre Coma Score \<5 in children 1 to 4 years, GCS \<14 for children ≥ 5 years); respiratory distress: age related tachypnea with sustained nasal flaring, deep breathing or subcostal retractions * Requiring hospitalization and parenteral artesunate for their malaria infection based on admitting physician assessment Exclusion Criteria: * P. falciparum RDT negative OR infection not confirmed by light microscopy or not reaching the predefined inclusion criterion parasitemia threshold according to age * Uncomplicated malaria infection not requiring hospitalization * Presenting with severe malaria anemia (SMA) alone (Hb \< 50g/L) * Known underlying illness: neurological or neurodegenerative disorders, cardiac, renal, or hepatic disease, diabetes, epilepsy, cerebral palsy, children known to be HIV-1 positive and receiving antiretroviral treatment\* * Previous treatment with a TZD * Unable to remain in research site region for the follow up period