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%] &lt5 years of age and 135 [38.6%] &ge5 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.
Burri, C.; Ferrari, G.; Ntuku, H. M.; Kitoto, A. T.; Duparc, S.; Hugo, P.; Mitembo, D. K.; Lengeler, C. Delayed Anemia After Treatment with Injectable Artesunate in the Democratic Republic of the Congo: A Manageable Issue. American Journal of Tropical Medicine and Hygiene 91 (4) 821-823. [DOI: 10.4269/ajtmh.14-0149]