Delayed-Onset Hemolytic Anemia in Patients with Travel-Associated Severe Malaria Treated with Artesunate, France, 2011–2013
نویسندگان
چکیده
Artesunate is the most effective treatment for severe malaria. However, delayed-onset hemolytic anemia has been observed in ≈20% of travelers who receive artesunate, ≈60% of whom require transfusion. This finding could discourage physicians from using artesunate. We prospectively evaluated a cohort of 123 patients in France who had severe imported malaria that was treated with artesunate; our evaluation focused on outcome, adverse events, and postartesunate delayed-onset hemolysis (PADH). Of the 123 patients, 6 (5%) died. Overall, 97 adverse events occurred. Among the 78 patients who received follow-up for >8 days after treatment initiation, 76 (97%) had anemia, and 21 (27%) of the 78 cases were recorded as PADH. The median drop in hemoglobin levels was 1.3 g/dL; 15% of patients with PADH had hemoglobin levels of <7 g/dL, and 1 required transfusion. Despite the high incidence of PADH, the resulting anemia remained mild in 85% of cases. This reassuring result confirms the safety and therapeutic benefit of artesunate.
منابع مشابه
Published Reports of Delayed Hemolytic Anemia After Treatment with Artesunate for Severe Malaria — Worldwide, 2010–2012
Artesunate has been recommended by the World Health Organization (WHO) as the first-line treatment for severe malaria since 2010. It is not licensed in the United States but is available from CDC under an investigational new drug (IND) protocol. During 2010-2012, a total of 19 cases of delayed hemolytic anemia after treatment of severe malaria with artesunate were published in the peer-reviewed...
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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...
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عنوان ژورنال:
دوره 21 شماره
صفحات -
تاریخ انتشار 2015