Intravenous vitamin b – complex and ferrous dextrane in malaria induced anemia: a single center prospective study

Abstract

Background: In sub - Saharan Africa countries Plasmodium falciparum malaria is the most important parasitic disease. Accordingly, malaria induced anemia is one of the main public health burden. Treatment for anemia depends on severity and cause. In severe cases a blood transfusion may be necessary. Blood supplies in Africa are not able to meet the demand and this often leads to high maternal and child mortality rates in the continent. Also, it has been estimated that 5 – 10% of HIV transmission in Africa is brought by contaminated blood transfusions. Aim of the Study: Was to explore the hemoglobin increase, clinical benefits and safety of intravenous administration of vitamin B – complex and ferrous dextrane combination in patients with acute moderate to severe malaria induced anemia in rural African setting. Methods: With the hypothesis of obtaining a hemoglobin increase of ≥ 1g/dl in at least 50% of patients, 89 patients were included in the study after diagnosis of malaria and moderate to severe anemia (Hb: 6 – 10 g/dl) was confirmed. Patients were treated twice daily for three consecutive days. Statistics: Analysis were undertaken on perprotocol basis. Wilcoxon rank test was used to compare the average hemoglobin value at baseline and end of treatment course. Correlation between patients’ age and average hemoglobin increase was assessed by Spearman’s rank correlation test. All tests were two-tailed and significance was reported at the 5% level. Results: 49 patients (55%) showed a treatment response, 21 (23,6%) improved clinically and 19 (21,3%) failed to respond to the treatment. The difference was found statistically significant. Average hemoglobin concentration at the end of treatment was found higher than baseline and the difference was considered statistically very significant (9 g/dl vs. 8 g/dl; p < 0,0001). Conclusion: The results of the present study show that this treatment should be considered a useful first line intervention in healthcare settings, especially in rural sub Saharan Africa where blood transfusion is a hardly available option.