Abstract
The use of artemisinin derivatives has become the mainstay in the treatment of both severe and uncomplicated falciparum malaria. The available report suggests that the derivatives are safe and well tolerated in most patients, with only a few cases of severe adverse drug reactions to some of these derivatives. In the present report, a 30-year-old breastfeeding mother and a resident of Ekpoma, Edo State, Nigeria, who on presentation was diagnosed with severe malaria, developed pruritus 4–6 h after receiving the first dose (150 mg) of intramuscular αβ-arteether. This condition became more intense with widespread pruritic rash and extensive erythematous eruptions and excoriating skin lesions following the second dose of the drug. However, the administration of the drug was discontinued on the third day with the eruptive lesions abating following the administration of antihistamines and steroids (loratadine and prednisolone) for 5 days. In conclusion, the clinical manifestation shows the case of an αβ-arteether-induced dermatitis secondary to an immediate hypersensitivity reaction, which is a rare occurrence with the drug. The adverse drug reaction to this agent also emphasizes the need for postmarketing surveillance and monitoring of most artemisinins, particularly in sub-Saharan Africa where they are being increasingly used for the treatment of malaria.
Highlights
Malaria is an agelong public health problem that is still ravaging Africa
A report from the World Health Organization (WHO) shows that the African region accounts for 92% of the global malaria burden compared to the Southeast Asian and Eastern Mediterranean regions, which contribute 5 and 2% to the global burden, respectively [1]
Malaria infection occurs following the bite of an infected female anopheles mosquito, which releases sporozoites into the blood of the human host
Summary
Malaria is an agelong public health problem that is still ravaging Africa. It accounts for two-thirds morbidity and mortality among children resident in sub-Saharan Africa. The quinolines have been the mainstay of treatment until the emergence of resistance to chloroquine, which was first reported in the Cambodia–Thailand border in the 1950s. This subsequently spread through Southeast Asia to other malaria-endemic regions of the world [4]. The artemisinin derivatives remain the most effective agents available and are being used in a combination regimen with antimalarials from other chemical groups and with different mechanisms of action with the advantage of ensuring rapid parasite clearance and delaying the emergence of drug-resistant strains in the population [5, 7, 8]. Reports are scanty about large-scale clinical trials with regard to the drug in sub-Saharan Africa; the case report lays credence to the need to mobilize tools and resources for active pharmacovigilance and monitoring of the drug to improve the safety of its use in the population
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