Clinical Illness and Outcomes in Nigerian Children with Persistent Early Appearing Anaemia Following Initiation of Artemisinin-Based Combination Treatments of Uncomplicated Falciparum Malaria.

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dc.contributor.authorFolarin, Onikepe
dc.date.accessioned2022-05-09T08:03:31Z
dc.date.available2022-05-09T08:03:31Z
dc.date.issued2019
dc.description.abstractIn non-anaemic children with malaria, early-appearing anaemia (EAA) is common following artemisininbased combination treatments (ACTs) and it may become persistent (PEAA). The factors contributing to and kinetics of resolution of the deficit in haematocrit from baseline (DIHFB) characteristic of ACTs-related PEAA were evaluated in 540 consecutive children with malaria treated with artemether-lumefantrine, artesunate-amodiaquine or dihydroartemisinin-piperaquine. Asymptomatic PEAA occurred in 62 children. In a multiple logistic regression model, a duration of illness 3 days before presentation, haematocrit <35% before and <25% one day after treatment initiation, drug attributable fall in haematocrit 6%, and treatment with dihydroartemisinin-piperaquine independently predicted PEAA. Overall, mean DIHFB was 5.7% (95% CI 4.8–6.6) 7 days after treatment initiation and was similar for all treatments. Time to 90% reduction in DIHFB was significantly longer in artemether-lumefantrine-treated children compared with other treatments. In a one compartment model, declines in DIHFB were monoexponential with overall mean estimated half-time of 3.9 days (95% CI 2.6–5.1), Cmax of 7.6% (95% CI 6.7–8.4), and Vd of 0.17 L/kg (95% CI 0.04–0.95). In Bland-Altman analyses, overall mean anaemia recovery time (AnRT) of 17.4 days (95% CI 15.5–19.4) showed insignificant bias with 4, 5 or 6 multiples of half-time of DIHFB. Ten children after recovery from PEAA progressed to late-appearing anaemia (LAA). Progression was associated with female gender and artesunateamodiaquine treatment. Asymptomatic PEAA is common following ACTs. PEAA or its progression to LAA may have implications for case and community management of anaemia and for anaemia control efforts in sub-Saharan Africa where ACTs have become first-line antimalarialsen_US
dc.identifier.urihttp://dspace.run.edu.ng:8080/jspui/handle/123456789/2814
dc.language.isoenen_US
dc.publisherParasiteen_US
dc.titleClinical Illness and Outcomes in Nigerian Children with Persistent Early Appearing Anaemia Following Initiation of Artemisinin-Based Combination Treatments of Uncomplicated Falciparum Malaria.en_US
dc.typeArticleen_US
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