51. Investigation of Four Cases of Stevens-Johnson Syndrome among Participants in a Mass Drug Administration Campaign with Sulfadoxine-Pyrimethamine and Primaquine in Haiti, 2020.
- Author
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Chang MA, Fouché B, LaFortune W, Holmes K, Rigodon J, Juin S, Marseille S, Rogier E, Green M, Kheradmand T, Moore SG, Gaul DA, Boncy J, and Telfort MA
- Subjects
- Humans, Primaquine adverse effects, Haiti epidemiology, Mass Drug Administration, Pandemics, SARS-CoV-2, Pyrimethamine adverse effects, Sulfadoxine adverse effects, Drug Combinations, Antimalarials adverse effects, Stevens-Johnson Syndrome etiology, Stevens-Johnson Syndrome drug therapy, Stevens-Johnson Syndrome epidemiology, COVID-19, Malaria drug therapy, Malaria epidemiology, Malaria prevention & control
- Abstract
In 2018, a mass drug administration (MDA) campaign for malaria elimination was piloted in Haiti. The pilot treated 36,338 people with sulfadoxine-pyrimethamine (SP) and primaquine; no severe adverse events were detected. In 2020, another MDA campaign using the same medications was implemented to mitigate an upsurge in malaria cases during the COVID-19 pandemic. Four cases of Stevens-Johnson syndrome (SJS) were identified among the 42,249 people who took the medications. Three of these individuals required hospitalization; all survived. In addition to SP ingestion, an investigation of potential causes for increased SJS cases identified that all four cases had human leukocyte antigens A*29 and/or B*44:03, another known risk factor for SJS. Additionally, three of the four case individuals had antibodies to SARS-CoV-2, and the fourth may have been exposed around the same time. These findings raise the possibility that recent SARS-CoV-2 infection may have contributed to the increased risk for SJS associated with SP exposure during the 2020 campaign.
- Published
- 2023
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