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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Delayed hemolysis after treatment with parenteral artesunate in African children with severe malaria - A double-center prospective study
Journal of Infectious Diseases, Volume 209, No. 12, Year 2014
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Description
Background. Parenteral artesunate is recommended as first-line therapy for severe malaria. While its efficacy is firmly established, data on safety are still incomplete. Delayed hemolysis has been described in hyperparasitemic nonimmune travelers, but it is unknown if African children are equally at risk. Methods. Children aged 6 to 120 months with severe malaria were followed up after treatment with parenteral artesunate in Lambaréné, Gabon, and Kumasi, Ghana. The primary outcome was incidence of delayed hemolysis on day 14. Results. In total, 72 children contributed complete data sets necessary for primary outcome assessment. Delayed hemolysis was detected in 5 children (7%), with 1 child reaching a nadir in hemoglobin of 2.8 g/dL. Patients with delayed hemolysis had higher parasite counts on admission (geometric mean parasite densities (GMPD) 306 968/μL vs 92 642/μL, P =. 028) and were younger (median age: 24 months vs 43 months, P =. 046) than the rest of the cohort. No correlation with sickle cell trait or glucose-6-phosphate-dehydrogenase deficiency was observed. Conclusions. Delayed hemolysis is a frequent and relevant complication in hyperparasitemic African children treated with parenteral artesunate for severe malaria. Physicians should be aware of this complication and consider prolonged follow-up. Clinical Trials Registration. Pan-African Clinical Trials Registry: PACTR201102000277177 (www.pactr.org). © 2013 The Author 2013.
Authors & Co-Authors
Rolling, Thierry
Unknown Affiliation
Agbenyega, Tsiri E.
Unknown Affiliation
Issifou, Saadou
Unknown Affiliation
Adégnika, Ayôla Akim
Unknown Affiliation
Sylverken, Justice
Unknown Affiliation
Spahlinger, Dorothee
Unknown Affiliation
Ansong, Daniel Ayirebi
Unknown Affiliation
Löhr, Sascha J.Z.
Unknown Affiliation
Burchard, Gerd Dieter
Unknown Affiliation
May, Juergen ü.
Unknown Affiliation
Mordmüller, Benjamin G.
Unknown Affiliation
Krishna, Prof Sanjeev
Unknown Affiliation
Kremsner, Peter G.
Unknown Affiliation
Cramer, Jakob Peter
Unknown Affiliation
Statistics
Citations: 82
Authors: 14
Affiliations: 8
Identifiers
Doi:
10.1093/infdis/jit841
ISSN:
00221899
e-ISSN:
15376613
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Gabon
Ghana