Post-malarial anemia in Mozambican children treated with quinine or artesunate: A retrospective observational study.

Abstract

OBJECTIVES:

This retrospective analysis performed in Manhiça, Southern Mozambique, aimed to describe the frequency of post-malarial anemia (measured as a decrease of hematocrit ≥10%) and the need for blood transfusions in children with severe malaria treated with intravenous quinine or parenteral artesunate.

METHODS:

All children <15 years admitted with a parasitologically-confirmed diagnosis of malaria from 1st January 2003 to 31st December 2017, alive at hospital discharge, and with at least one measurement of hematocrit within 28 days after hospital discharge, detected by passive case detection, were included.

RESULTS:

The overall prevalence of post-malarial anemia observed in the study was 23.13%, with an estimated incidence rate of 288.84 episodes/1,000 children-month at risk in the follow-up period (28 days after discharge). There were no differences between treatment groups, although the study showed a higher association between blood transfusions and artesunate treatment.

CONCLUSIONS:

In this setting, children with severe malaria frequently present a meaningful decrease of hematocrit (>=10%) in the first weeks after their episode, sometimes requiring blood transfusions. Because of the high underlying prevalence of anemia in malaria-endemic settings, all children with severe malaria need to be actively followed up, irrespective of the treatment received.

• Authors: Rosauro Varo, Llorenç Quintó, Antonio Sitoe, Lola Madrid, Sozinho Acácio, Pio Vitorino, Ana Marta Valente, Alfredo Mayor, Daniel Camprubí, Jose Muñoz, Gizela Bambo, Eusebio Macete, Clara Menéndez, Pedro L Alonso, Pedro Aide, Quique Bassat
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 96 Pg. 655-662 (Jul 2020) ISSN: 1878-3511 [Electronic] Canada
• PMID: 32497814 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Antimalarials
• Artesunate
• Quinine

Topics

• Administration, Intravenous
• Adolescent
• Anemia (epidemiology, etiology)
• Antimalarials (administration & dosage, adverse effects)
• Artesunate (administration & dosage, adverse effects)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Malaria (complications, drug therapy)
• Male
• Mozambique (epidemiology)
• Quinine (administration & dosage, adverse effects)
• Retrospective Studies