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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005355naa a2200541 4500
001oai:DiVA.org:uu-359806
003SwePub
008180924s2017 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:136112007
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3598062 URI
0247 a https://doi.org/10.1186/s12879-017-2530-62 DOI
0247 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 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Zwang, Julien4 aut
2451 0a Haemoglobin changes and risk of anaemia following treatment for uncomplicated falciparum malaria in sub-Saharan Africa
264 c 2017-06-23
264 1b 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 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Infektionsmedicin0 (SwePub)302092 hsv//swe
650 7a 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
7001 a D'Alessandro, Umbertou MRC Unit, Banjul, Gambia;London Sch Hyg & Trop Med, London, England;Inst Trop Med, Antwerp, Belgium4 aut
7001 a Ndiaye, Jean-Louisu Cheikh Anta Diop Univ, Dept Parasitol, Fac Med, Dakar, Senegal4 aut
7001 a Djimde, Abdoulaye A.u Univ Sci Tech & Technol Bamako, Fac Pharm, Dept Epidemiol Parasit Dis, Malaria Res & Training Ctr, Bamako, Mali4 aut
7001 a Dorsey, Grantu Univ Calif San Francisco, Dept Med, San Francisco, CA USA4 aut
7001 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
7001 a Karema, Corineu Swiss Trop & Publ Hlth Inst, Basel, Switzerland;Univ Basel, Basel, Switzerland4 aut
7001 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
7102 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
7730 t BMC Infectious Diseasesd : Springer Science and Business Media LLCg 17q 17x 1471-2334
8564 u https://doi.org/10.1186/s12879-017-2530-6y Fulltext
8564 u https://uu.diva-portal.org/smash/get/diva2:1250390/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 u https://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-017-2530-6
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-359806
8564 8u https://doi.org/10.1186/s12879-017-2530-6
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:136112007

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