Sökning: onr:"swepub:oai:DiVA.org:uu-359806" > Haemoglobin changes...
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000 | 05355naa a2200541 4500 | |
001 | oai:DiVA.org:uu-359806 | |
003 | SwePub | |
008 | 180924s2017 | |||||||||||000 ||eng| | |
009 | oai:prod.swepub.kib.ki.se:136112007 | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3598062 URI |
024 | 7 | a https://doi.org/10.1186/s12879-017-2530-62 DOI |
024 | 7 | a http://kipublications.ki.se/Default.aspx?queryparsed=id:1361120072 URI |
040 | a (SwePub)uud (SwePub)ki | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Zwang, Julien4 aut |
245 | 1 0 | a Haemoglobin changes and risk of anaemia following treatment for uncomplicated falciparum malaria in sub-Saharan Africa |
264 | c 2017-06-23 | |
264 | 1 | b Springer Science and Business Media LLC,c 2017 |
338 | a electronic2 rdacarrier | |
520 | a Background: Anaemia is common in malaria. It is important to quantitate the risk of anaemia and to distinguish factors related to the natural history of disease from potential drug toxicity. Methods: Individual-patient data analysis based on nine randomized controlled trials of treatments of uncomplicated falciparum malaria from 13 sub-Saharan African countries. Risk factors for reduced haemoglobin (Hb) concentrations and anaemia on presentation and after treatment were analysed using mixed effect models. Results: Eight thousand eight hundred ninety-seven patients (77.0% < 5 years-old) followed-up through 28 days treated with artemisinin combination therapy (ACT, 90%, n = 7968) or non-ACT. At baseline, under 5' s had the highest risk of anaemia (77.6% vs. 32.8%) and higher parasitaemia (43,938 mu l) than older subjects (2784 mu l). Baseline anaemia increased the risk of parasitological recurrence. Hb began to fall after treatment start. In under 5' s the estimated nadir was similar to 35 h (range 29-48), with a drop of -12.8% from baseline (from 9.8 g/dl to 8.7 g/dl, p = 0.001); in under 15's, the mean Hb decline between day 0-3 was -4.7% (from 9.4 to 9.0 g/dl, p = 0.001). The degree of Hb loss was greater in patients with high pre-treatment Hb and parasitaemia and with slower parasite reduction rates, and was unrelated to age. Subsequently, Hb increased linearly (+0.6%/day) until day 28, to reach + 13.8% compared to baseline. Severe anaemia (< 5 g/dl, 2 per 1000 patients) was transient and all patients recovered after day 14, except one case of very severe anaemia associated with parasite recurrence at day 28. There was no systematic difference in Hb concentrations between treatments and no case of delayed anaemia. Conclusion: On presentation with acute malaria young children with high parasitaemia have the highest risk of anaemia. The majority of patients experience a drop in Hb while on treatment as early as day 1-2, followed by a linear increase through follow-up. The degree of the early Hb dip is determined by pre-treatment parasitaemia and parasite clearance rates. Hb trends and rick of anaemia are independent of treatment. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Infektionsmedicin0 (SwePub)302092 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Infectious Medicine0 (SwePub)302092 hsv//eng |
653 | a P. Falciparum | |
653 | a Malaria | |
653 | a Artemisinin | |
653 | a Anaemia | |
653 | a Haemolysis | |
653 | a Artesunate | |
653 | a Amodiaquine | |
653 | a Sub-Saharan Africa | |
700 | 1 | a D'Alessandro, Umbertou MRC Unit, Banjul, Gambia;London Sch Hyg & Trop Med, London, England;Inst Trop Med, Antwerp, Belgium4 aut |
700 | 1 | a Ndiaye, Jean-Louisu Cheikh Anta Diop Univ, Dept Parasitol, Fac Med, Dakar, Senegal4 aut |
700 | 1 | a Djimde, Abdoulaye A.u Univ Sci Tech & Technol Bamako, Fac Pharm, Dept Epidemiol Parasit Dis, Malaria Res & Training Ctr, Bamako, Mali4 aut |
700 | 1 | a Dorsey, Grantu Univ Calif San Francisco, Dept Med, San Francisco, CA USA4 aut |
700 | 1 | a Mårtensson, Andreas,d 1963-u Uppsala universitet,Internationell barnhälsa och nutrition,Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden4 aut0 (Swepub:uu)andma331 |
700 | 1 | a Karema, Corineu Swiss Trop & Publ Hlth Inst, Basel, Switzerland;Univ Basel, Basel, Switzerland4 aut |
700 | 1 | a Olliaro, Piero L.u Special Programme Res & Training Trop Dis WHO TDR, 20 Ave Appia, CH-1211 Geneva, Switzerland;Univ Oxford, Churchill Hosp, Nuffield Dept Med, Ctr Trop Med & Global Hlth, Oxford OX3 7LJ, England;Univ Basel, Basel, Switzerland4 aut |
710 | 2 | a MRC Unit, Banjul, Gambia;London Sch Hyg & Trop Med, London, England;Inst Trop Med, Antwerp, Belgiumb Cheikh Anta Diop Univ, Dept Parasitol, Fac Med, Dakar, Senegal4 org |
773 | 0 | t BMC Infectious Diseasesd : Springer Science and Business Media LLCg 17q 17x 1471-2334 |
856 | 4 | u https://doi.org/10.1186/s12879-017-2530-6y Fulltext |
856 | 4 | u https://uu.diva-portal.org/smash/get/diva2:1250390/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print |
856 | 4 | u https://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-017-2530-6 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-359806 |
856 | 4 8 | u https://doi.org/10.1186/s12879-017-2530-6 |
856 | 4 8 | u http://kipublications.ki.se/Default.aspx?queryparsed=id:136112007 |
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