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|Title: ||Delayed Hemolysis After Treatment With Parenteral Artesunate in African Children With Severe Malaria—A Double-center Prospective Study|
|Authors: ||Agbenyega, Edward Tsiri|
Adegnika, yola Akim
|Issue Date: ||19-Sep-2013|
|Publisher: ||Oxford University Press|
|Citation: ||Oxford University Press, 2013|
|Abstract: ||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
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
Clinical Trials Registration. Pan-African Clinical Trials Registry: PACTR201102000277177 (www.pactr.org).|
|Description: ||This article is published at Oxford University Press, and also available at DOI: 10.1093/infdis/jit841|
|URI: ||DOI: 10.1093/infdis/jit841|
|Appears in Collections:||College of Health Sciences|
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