HEMATOLOGICAL CHANGES AMONG MALARIA PATIENTS FOLLOWING TREATMENT WITH ARTEMISININ DERIVATIVES IN NANORO, BURKINA FASO
Received: 14 May 2024 / Accepted: 30 Jul 2024 / Published: 3 Oct 2024
Abstract
Background:
Artemisinin and its derivatives are key for the treatment of malaria (severe and uncomplicated). They are generally safe and well tolerated. However, some cases of hematological toxicity have been reported. In this study, we assessed hematological toxicity using new parameters derived from hematology analyzer, the XN-31.
Methods:
Data from prospective study which aims to assess the diagnostic accuracy of new hematology analyzer (the Sysmex XN-31) to detect malaria parasitemia were used. Data including the previous treatment and biological tests, including full blood count and malaria microscopy were recorded. Participants were divided into three groups based on malaria test result and treatment with artemisinin derivatives in: (i) malaria negative with no artemisinin treatment (Mal-/ACT-), (ii) malaria negative with artemisinin treatment (Mal-/ACT+) and (iii) malaria positive with artemisinin treatment (Mal+/ACT+). Erythropoiesis was assessed using reticulocytes absolutes count (Ret-Ab) and reticulocytes production index (RPI), and free hemoglobin level for hemolysis.
Results:
A total of 292 (31.0%) participants enrolled in the main diagnostic accuracy study were enrolled in this study; 140 (47.9%) received artemisinin derivatives treatment at admission and 93 (31.8%) had positive malaria smear. After multivariable analysis and adjustment for hemoglobin, age and C reactive protein (CRP), the delta Ret-Ab (measuring the baseline and follow-up levels) did not significantly differ in the Mal+/ACT+ (β=1.1, se(β)=5.4, p=0.8) and Mal-/ACT+ groups (β=5.1, se(β)=5.5, P=0.4) compared to Mal-/ACT- group. The same hold for the delta RPI. Free-Hb levels were elevated in the groups treated with ACT (Mal-/ACT+ and Mal+/ACT+) compared to Mal-/ACT-. However, this difference remains significant after adjustment for parasite density for only Mal+/ACT+ group with a median delta free hemoglobin of 0.4g/dl.
Conclusion:
Our study did not provide evidence of reticulocytopenia. However, post-treatment hemolysis with limited impact was observed. Artemisinin and its derivatives remain, therefore a well-tolerated potent antimalarial drug.
Keywords: Malaria, Artemisinin and derivatives, Erythropoiesis, Hemolysis, Anemia
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CITE
KABORE, B.; TAHITA, M.C.; DIALLO, S.; LOMPO, P.; BOGNINI, J.D.; SAWADOGO, Y.E.; YOUGBARE, S.; KAZIENGA, A.; TINTO, H. HEMATOLOGICAL CHANGES AMONG MALARIA PATIENTS FOLLOWING TREATMENT WITH ARTEMISININ DERIVATIVES IN NANORO, BURKINA FASO. ajpme 2024, 2, 11.
KABORE B, TAHITA MC, DIALLO S, LOMPO P, BOGNINI JD, SAWADOGO YE, YOUGBARE S, KAZIENGA A, TINTO H. HEMATOLOGICAL CHANGES AMONG MALARIA PATIENTS FOLLOWING TREATMENT WITH ARTEMISININ DERIVATIVES IN NANORO, BURKINA FASO. African Journal of Parasitology, Mycology and Entomology. 2024; 2(1):11.
KABORE, Bérenger; TAHITA, Marc Chrisian; DIALLO, Salou; LOMPO, Palpougouni; BOGNINI, Joel Dofinissery; SAWADOGO, Yabre Edmond; YOUGBARE, Sibidou; KAZIENGA, Adama; TINTO, Halidou. 2024. "HEMATOLOGICAL CHANGES AMONG MALARIA PATIENTS FOLLOWING TREATMENT WITH ARTEMISININ DERIVATIVES IN NANORO, BURKINA FASO." ajpme 2, no. 1: 11.
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