Volume 91, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Cases of delayed hemolytic anemia have been described after treatment with injectable artesunate, the current World Health Organization (WHO)–recommended first-line drug for the treatment of severe malaria. A total of 350 patients (215 [61.4%] < 5 years of age and 135 [38.6%] ≥ 5 years of age) were followed-up after treatment with injectable artesunate for severe malaria in hospitals and health centers of the Democratic Republic of the Congo. Complete series of hemoglobin (Hb) measurements were available for 201 patients. A decrease in Hb levels between 2 and 5 g/dL was detected in 23 (11.4%) patients during the follow-up period. For five patients, Hb levels decreased below 5 g/dL during at least one follow-up visit. All cases of delayed anemia were clinically manageable and resolved within one month.

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  1. World Health Organization, 2006. Guidelines for the Treatment of Severe Malaria. Geneva: World Health Organization.
    [Google Scholar]
  2. World Health Organization, 2011. Guidelines for Treatment of Malaria. Second edition. Geneva: World Health Organization. Available at: http://www.who.int/malaria/publications/atoz/9789241547925/en. Accessed January 27, 2014.
    [Google Scholar]
  3. World Health Organization, 2012. World Malaria Report 2012, Section 8.5, Cases and Deaths Averted 2001–2010. Geneva: World Health Organization.
    [Google Scholar]
  4. Centers for Disease Control and Prevention, 2013. Published reports of delayed hemolytic anemia after treatment with artesunate for severe malaria–worldwide, 2010–2012. MMWR Morb Mortal Wkly Rep 62: 58.
    [Google Scholar]
  5. Rolling T, Agbenyega T, Issifou S, Adegnika AA, Sylverken J, Spahlinger D, Ansong D, Lohr SJ, Burchard GD, May J, Mordmuller B, Krishna S, Kremsner PG, Cramer JP, 2014. Delayed hemolysis after treatment with parenteral artesunate in African children with severe malaria: a double-center prospective study. J Infect Dis J 209: 19211928.[Crossref]
    [Google Scholar]
  6. Ladhani SD, Patel VS, El Bashir H, 2005. Changes in laboratory features of 192 children with imported falciparum malaria treated with quinine. Pediatr Infect Dis J 24: 10171020.[Crossref]
    [Google Scholar]
  7. World Health Organization. Information Note on Delayed Haemolytic Anaemia following Treatment with Artesunate. Available at: http://www.who.int/malaria/publications/atoz/who_note_delayed_haemolytic_anaemia_oct13.pdf. Accessed February 16, 2014.
    [Google Scholar]
  8. Medicines for Malaria Venture (MMV). Expert Group Meeting on the Safety Profile of Injectable Artesunate. Available at: http://www.mmv.org/newsroom/events/expert-group-meeting-safety-profile-injectable-artesunate. Accessed February 16, 2014.
    [Google Scholar]

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  • Received : 12 Mar 2014
  • Accepted : 24 May 2014
  • Published online : 01 Oct 2014
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