Document Detail

The course of anaemia after the treatment of acute, falciparum malaria.
MedLine Citation:
PMID:  9797826     Owner:  NLM     Status:  MEDLINE    
To determine the course of anaemia following treatment for acute falciparum malaria, 72 adult Thai patients were followed for 4 weeks after starting effective therapy. Using the criteria of haemoglobin concentrations of < 13 g/dl in males and < 12 g/dl in females to define anaemia, all but two (97%) of the patients were anaemic at some point during the study period. At weekly observations, the erythropoietic response of each patient with anaemia was categorized clinically, on the basis of absolute reticulocyte counts (ARC) and indirect bilirubin concentrations (IBC). At 4 weeks, 40 (56%) of the patients were still anaemic. The results of tests on samples of peripheral blood from these 40 patients were consistent with hypoproliferative erythropoiesis (low-normal ARC and IBC; 33 patients), ineffective erythropoiesis (low-normal ARC but elevated IBC; five patients) or an appropriate response (elevated ARC and normal IBC; two patients). Of the variables measured at the time of enrolment into the study, only low serum albumin (P = 0.002) and elevated direct bilirubin (P = 0.009) were independently associated with persisting anaemia at 4 weeks. Anaemia may therefore persist in about one in every two Thai patients for up to 28 days after beginning effective treatment for acute Plasmodium falciparum malaria, hypoproliferative erythropoiesis appearing to be the most common mechanism of this anaemia. While it is likely that the malarial episode itself is somehow responsible for these persistent haematological changes, other, underlying, chronic processes might have a contributory role. Whatever the cause, the continuing anaemia appears to be related to the degree of hepatic dysfunction on admission.
L H Camacho; V R Gordeuk; P Wilairatana; P Pootrakul; G M Brittenham; S Looareesuwan
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of tropical medicine and parasitology     Volume:  92     ISSN:  0003-4983     ISO Abbreviation:  Ann Trop Med Parasitol     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-11-13     Completed Date:  1998-11-13     Revised Date:  2009-05-18    
Medline Journal Info:
Nlm Unique ID:  2985178R     Medline TA:  Ann Trop Med Parasitol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  525-37     Citation Subset:  IM    
Department of Medicine, George Washington University Medical Center, Washington, DC 20037, USA.
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MeSH Terms
Anemia / blood*,  etiology
Antimalarials / therapeutic use
Bilirubin / blood
Malaria, Falciparum / blood*,  drug therapy
Retrospective Studies
Time Factors
Treatment Outcome
Grant Support
FD-R-00975-03/FD/FDA HHS; UO1 A135827-01//PHS HHS
Reg. No./Substance:
0/Antimalarials; 635-65-4/Bilirubin

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