Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal

Background. Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. Plasmodium falciparum infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemic...

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Main Authors: Khadime Sylla, Roger Tine, Doudou Sow, Souleye Lelo, Annie Abiola, Jean Louis NDiaye, Magatte NDiaye, Kuaku Folly, Léon Amath NDiaye, Oumar Gaye, Babacar Faye
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Parasitology Research
Online Access:http://dx.doi.org/10.1155/2022/1635791
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author Khadime Sylla
Roger Tine
Doudou Sow
Souleye Lelo
Annie Abiola
Jean Louis NDiaye
Magatte NDiaye
Kuaku Folly
Léon Amath NDiaye
Oumar Gaye
Babacar Faye
author_facet Khadime Sylla
Roger Tine
Doudou Sow
Souleye Lelo
Annie Abiola
Jean Louis NDiaye
Magatte NDiaye
Kuaku Folly
Léon Amath NDiaye
Oumar Gaye
Babacar Faye
author_sort Khadime Sylla
collection DOAJ
description Background. Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. Plasmodium falciparum infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemical and hematological parameters during uncomplicated malaria in patients treated with ACTs. Methods. Data from patient with uncomplicated Plasmodium falciparum malaria were pooled from different open-randomized trial evaluating the efficacy of Artesunate-Mefloquine (ASMQ), Artesunate-Amodiaquine (ASAQ), Artemether-Lumefantrine (AL), and Dihydro-artemisinin-Piperaquine (DHAPQ) combinations. Biochemical (transaminases, creatinine, and bilirubin) and hematological (hemoglobin and platelet levels) parameters were performed at baseline (D0) and at day 7 after treatment (D7). Data were analyzed as both continuous and categorical variables with 95% confidence interval. Risks and trends were calculated using multivariate logistic random effect models. Results. A total of 720 patients with completed biological data were included in the analysis (320 in the AL arm, 160 in the ASMQ arm, 120 in the DHAPQ arm, and 88 in the ASAQ arm). The mean age of the patients was 9.43±9.1 years. Male subjects represented 58.47% (sex ratio was 1.4 for males). The mean hemoglobin level at inclusion (D0) was 9.79 g/dl and anemia (Hb<11 g/dl) was 71.43% (aOR=1.16 0.68−1.98p=0.57). At D7, hemoglobin level was 9.63 g/dl and anemia was significantly more frequent (78.29% [p=0.002]). The mean platelet count at day 0 was 154075.5 platelets/mm3 of blood and 339328.7 platelets/mm3 at day 7. Thrombocytopenia was about 53.61% and was associated with malaria (aOR=3.4 2.18−5.3p<10−3). 19.58% of patients had abnormal ALT and 40.28% had abnormal AST at D0. 27.22% of patients had normal bilirubin at D0. Renal function was normal in all patients in the study. Normalization of transaminases was noted between D0 and D7. The percentage of subjects with normal bilirubin increased between D0 and D7. Renal function did not vary significantly between D0 and D7. Conclusion. Results from this analysis showed that subjects with high parasitaemia had a greater risk of anemia and thrombocytopenia. Artemisinin combinations were well-tolerated as no major biological disturbances were noted. The effects of ACTs on hematologic and biochemical parameters were not different.
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spelling doaj-art-dccc95714fa146e19eb794386d3f53892025-02-03T05:57:59ZengWileyJournal of Parasitology Research2090-00312022-01-01202210.1155/2022/1635791Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, SenegalKhadime Sylla0Roger Tine1Doudou Sow2Souleye Lelo3Annie Abiola4Jean Louis NDiaye5Magatte NDiaye6Kuaku Folly7Léon Amath NDiaye8Oumar Gaye9Babacar Faye10Département de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieDépartement de Parasitologie-MycologieBackground. Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. Plasmodium falciparum infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemical and hematological parameters during uncomplicated malaria in patients treated with ACTs. Methods. Data from patient with uncomplicated Plasmodium falciparum malaria were pooled from different open-randomized trial evaluating the efficacy of Artesunate-Mefloquine (ASMQ), Artesunate-Amodiaquine (ASAQ), Artemether-Lumefantrine (AL), and Dihydro-artemisinin-Piperaquine (DHAPQ) combinations. Biochemical (transaminases, creatinine, and bilirubin) and hematological (hemoglobin and platelet levels) parameters were performed at baseline (D0) and at day 7 after treatment (D7). Data were analyzed as both continuous and categorical variables with 95% confidence interval. Risks and trends were calculated using multivariate logistic random effect models. Results. A total of 720 patients with completed biological data were included in the analysis (320 in the AL arm, 160 in the ASMQ arm, 120 in the DHAPQ arm, and 88 in the ASAQ arm). The mean age of the patients was 9.43±9.1 years. Male subjects represented 58.47% (sex ratio was 1.4 for males). The mean hemoglobin level at inclusion (D0) was 9.79 g/dl and anemia (Hb<11 g/dl) was 71.43% (aOR=1.16 0.68−1.98p=0.57). At D7, hemoglobin level was 9.63 g/dl and anemia was significantly more frequent (78.29% [p=0.002]). The mean platelet count at day 0 was 154075.5 platelets/mm3 of blood and 339328.7 platelets/mm3 at day 7. Thrombocytopenia was about 53.61% and was associated with malaria (aOR=3.4 2.18−5.3p<10−3). 19.58% of patients had abnormal ALT and 40.28% had abnormal AST at D0. 27.22% of patients had normal bilirubin at D0. Renal function was normal in all patients in the study. Normalization of transaminases was noted between D0 and D7. The percentage of subjects with normal bilirubin increased between D0 and D7. Renal function did not vary significantly between D0 and D7. Conclusion. Results from this analysis showed that subjects with high parasitaemia had a greater risk of anemia and thrombocytopenia. Artemisinin combinations were well-tolerated as no major biological disturbances were noted. The effects of ACTs on hematologic and biochemical parameters were not different.http://dx.doi.org/10.1155/2022/1635791
spellingShingle Khadime Sylla
Roger Tine
Doudou Sow
Souleye Lelo
Annie Abiola
Jean Louis NDiaye
Magatte NDiaye
Kuaku Folly
Léon Amath NDiaye
Oumar Gaye
Babacar Faye
Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal
Journal of Parasitology Research
title Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal
title_full Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal
title_fullStr Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal
title_full_unstemmed Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal
title_short Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal
title_sort anemia thrombocytopenia and changes in biochemical parameters occurring in patients with uncomplicated plasmodium falciparum malaria data analysis from antimalarial efficacy randomized trials in dakar and kaolack regions senegal
url http://dx.doi.org/10.1155/2022/1635791
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