Background Malaria is a parasitic disease caused by the parasite Plasmodium falciparum that is transmitted through the bite of infected Anopheles female mosquitoes. It is a deadly disease that requires diagnosis and urgent treatment. The treatment is based on the combination of artemisinin derivatives and another drug. In 2016, according to the latest global report of malaria, there were 216 million cases of malaria and 4 45 000 deaths due to malaria.
Purpose To evaluate the efficacy and safety of artemisinin derivatives in the treatment of malaria.
Material and methods We carried out a retrospective observational study in the use of piperaquine 320 mg/dihydroartemisin 40 mg and intravenous (IV) artesunate from August 2017 to August 2018 in a district hospital in the south of Spain. Artesunte IV treatment was used in patients with malaria, and the severity criteria was: decreased level of consciousness, convulsions, acute respiratory failure, bilirubin greater than 2.5 mg/dL, spontaneous bleeding, hypoglycaemia, metabolic acidosis, acute renal failure, haemoglobinuria, glycaemia <40 mg/dl metabolic acidosis, hyperlactacidaemia, acute renal failure (serum creatinine >3 mg/dL), severe normocytic anaemia Hb <5 g/dL and parasitaemia >4%. Data collected: sex, age, origin country, prior consultation at the international vaccination centre and chemoprophylaxis against malaria, treatment with artesunate IV, initial parasitaemia (%), parasitaemia at 24 hours (%), parasitaemia at 48 hours (%), hospitalisation stay (days), adverse effects and readmission due to malaria recurrence. The data was obtained from the digital clinical history.
Results Patients: 32, 29 (90.6%) men. Average age: 35.4 years (18–48). Twenty-one (65.6%) patients came from Mali, five (15.6%) from Senegal, two (6.3%) from Gambia, two (6.3%) from Equatorial Guinea, one (3.1%) form Ivory Coast and one (3.1%) from Ghana. Six (18.8%) patients went for prior consultation in international vaccination but did not complete chemoprophylaxis. Five (15.6%) patients were treated with artesunate IV. Initial parasitaemia: 2.65%. After 24 hours of treatment, 11 (34.4%) patients presented parasitaemia. After 48 hours, no patient presented parasitaemia. 28.1% of the patients presented adverse effects. Five (55.6%) patients developed thrombocytopenia, three (33.3%) anaemia, two (22.2%) headache and one (11.1%) dizziness. Average hospital stay in patients with severity criteria: 4.2 days. Average hospital stay in patients without severity criteria: 2.3 days.
Conclusion Artemisinin derivatives are highly effective. They were effective in 100% of cases. Adverse effects were not serious and reversed after treatment was completed. No resistances to treatment were found in any cases.
References and/or acknowledgements No conflict of interest.
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