Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border.
Malar J
; 17(1): 30, 2018 Jan 15.
Article
em En
| MEDLINE
| ID: mdl-29334942
ABSTRACT
BACKGROUND:
Malaria has declined dramatically along the Thai-Myanmar border in recent years due to malaria control and elimination programmes. However, at the same time, artemisinin resistance has spread, raising concerns about the efficacy of parenteral artesunate for the treatment of severe malaria. CASE PRESENTATION In November 2015 and April 2017, two patients were treated for severe malaria with parenteral artesunate. Quinine was added within 24 h due to an initial poor response to treatment. The first patient died within 24 h of starting treatment and the second did not clear his peripheral parasitaemia until 11 days later. Genotyping revealed artemisinin resistance Kelch-13 markers.CONCLUSIONS:
Reliable efficacy of artesunate for the treatment of severe malaria may no longer be assured in areas where artemisinin resistance has emerged. Empirical addition of parenteral quinine to artesunate for treatment is recommended as a precautionary measure.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Plasmodium falciparum
/
Quinina
/
Resistência a Medicamentos
/
Malária Falciparum
/
Artesunato
/
Antimaláricos
Limite:
Adolescent
/
Adult
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Malar J
Assunto da revista:
MEDICINA TROPICAL
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Tailândia