1. Delayed-Onset Hemolytic Anemia in Patients with Travel-Associated Severe Malaria Treated with Artesunate, France, 2011-2013.
- Author
-
Jauréguiberry, Stéphane, Thellier, Marc, Alioune Ndour, Papa, Ader, Flavie, Roussel, Camille, Sonneville, Romain, Mayaux, Julien, Matheron, Sophie, Angoulvant, Adela, Wyplosz, Benjamin, Rapp, Christophe, Pistone, Thierry, Lebrun-Vignes, Bénédicte, Kendjo, Eric, Danis, Martin, Houzé, Sandrine, Bricaire, François, Mazier, Dominique, Buffet, Pierre, and Caumes, Eric
- Subjects
ARTEMISININ ,TRAVEL hygiene ,MALARIA ,MALARIA treatment ,DRUG side effects - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF