Abstract
Cases of delayed hemolytic anemia have been described after treatment with injectable artesunate, the current World Health Organization (WHO)–recommended first-line drug for the treatment of severe malaria. A total of 350 patients (215 [61.4%] < 5 years of age and 135 [38.6%] ≥ 5 years of age) were followed-up after treatment with injectable artesunate for severe malaria in hospitals and health centers of the Democratic Republic of the Congo. Complete series of hemoglobin (Hb) measurements were available for 201 patients. A decrease in Hb levels between 2 and 5 g/dL was detected in 23 (11.4%) patients during the follow-up period. For five patients, Hb levels decreased below 5 g/dL during at least one follow-up visit. All cases of delayed anemia were clinically manageable and resolved within one month.
Highlights
Acute Plasmodium falciparum malaria and improperly treated uncomplicated malaria can progress rapidly, especially in young children and almost invariably results in death.[1]
Cases of delayed hemolytic anemia have been described after treatment with injectable artesunate, the current World Health Organization (WHO)–recommended first-line drug for the treatment of severe malaria
The second edition of the WHO guidelines for the treatment of malaria updated in April 2011 recommends injectable artesunate for the management of severe malaria in all age groups and epidemiologic settings.[2,3]
Summary
Acute Plasmodium falciparum malaria and improperly treated uncomplicated malaria can progress rapidly, especially in young children and almost invariably results in death.[1]. Cases of delayed hemolytic anemia have been described after treatment with injectable artesunate, the current World Health Organization (WHO)–recommended first-line drug for the treatment of severe malaria. A total of 350 patients (215 [61.4%] < 5 years of age and 135 [38.6%] 3 5 years of age) were followed-up after treatment with injectable artesunate for severe malaria in hospitals and health centers of the Democratic Republic of the Congo.
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