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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15760

Title: Delayed Hemolysis After Treatment With Parenteral Artesunate in African Children With Severe Malaria—A Double-center Prospective Study
Authors: Agbenyega, Edward Tsiri
Rolling, Thierry
Issifou, Saadou
Adegnika, yola Akim
Sylverken, Justice
Keywords: hemolysis;
African children.
Severe malaria;
adverse events;
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 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).
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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