Delayed-Onset Hemolytic Anemia in Patients with Travel-Associated Severe Malaria Treated with Artesunate, France, 2011–2013

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Jauréguiberry, Stéphane ; Thellier, Marc ; Ndour, Papa Alioune ; 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 ; Caumes, Eric
• Corporate Authors:
  French Artesunate Working Group
• Description:
  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.
• Subjects:
  Artesunate Delayed-Onset Delayed-Onset Hemolytic Anemia In Patients With Travel-Associated Severe Malaria Treated With Artesunate, France, 2011–2013 France Hemolysis Hemolytic Anemia Imported Incidence Malaria Outcome Parasites Plasmodium Falciparum Research Safety Therapeutic Benefit Travel-Associated Travelers Vector-Borne Infections

  More +
• Source:
  Emerg Infect Dis. 21(5):804-812.
• Document Type:
  Journal Article
• Volume:
  21
• Issue:
  5
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:4a9d5c8c9c5f87df87ffdafe8d1d0d66c4ab199e7a641771de6541927fd1b12b
• Download URL:
  https://stacks.cdc.gov/view/cdc/30888/cdc_30888_DS1.pdf
• File Type:
  [PDF - 1.26 MB ]