Publications

@article{Mansoor2022,

title = {Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data},

author = {Rashid Mansoor and Robert J. Commons and Nicholas M. Douglas and Benjamin Abuaku and Jane Achan and Ishag Adam and George O. Adjei and Martin Adjuik and Bereket H. Alemayehu and Richard Allan and Elizabeth N. Allen and Anupkumar R. Anvikar and Emmanuel Arinaitwe and Elizabeth A. Ashley and Hazel Ashurst and Puji B. S. Asih and Nathan Bakyaita and Hubert Barennes and Karen I. Barnes and Leonardo Basco and Quique Bassat and Elisabeth Baudin and David J Bell and Delia Bethell and Anders Bjorkman and Caroline Boulton and Teun Bousema and Philippe Brasseur and Hasifa Bukirwa and Rebekah Burrow and Verena I. Carrara and Michel Cot and Umberto D’Alessandro and Debashish Das and Sabyasachi Das and Timothy M. E. Davis and Meghna Desai and Abdoulaye A. Djimde and Arjen M. Dondorp and Grant Dorsey and Chris J. Drakeley and Stephan Duparc and Emmanuelle Espi\'{e} and Jean-Francois Etard and Catherine Falade and Jean Francois Faucher and Scott Filler and Carole Fogg and Mark Fukuda and Oumar Gaye and Blaise Genton and Awab Ghulam Rahim and Julius Gilayeneh and Raquel Gonzalez and Rebecca F. Grais and Francesco Grandesso and Brian Greenwood and Anastasia Grivoyannis and Christoph Hatz and Eva Maria Hodel and Georgina S. Humphreys and Jimee Hwang and Deus Ishengoma and Elizabeth Juma and S. Patrick Kachur and Piet A. Kager and Erasmus Kamugisha and Moses R. Kamya and Corine Karema and Kassoum Kayentao and Adama Kazienga and Jean-Ren\'{e} Kiechel and Poul-Erik Kofoed and Kwadwo Koram and Peter G. Kremsner and David G. Lalloo and Moses Laman and Sue J. Lee and Bertrand Lell and Amelia W. Maiga and Andreas Mr{a}rtensson and Mayfong Mayxay and Wilfred Mbacham and Rose McGready and Herv\'{e} Menan and Didier M\'{e}nard and Frank Mockenhaupt and Brioni R. Moore and Olaf M\"{u}ller and Alain Nahum and Jean-Louis Ndiaye and Paul N. Newton and Billy E. Ngasala and Frederic Nikiema and Akindeh M. Nji and Harald Noedl and Francois Nosten and Bernhards R. Ogutu and Olusola Ojurongbe and Lyda Osorio and Jean-Bosco Ou\'{e}draogo and Seth Owusu-Agyei and Anil Pareek and Louis K. Penali and Patrice Piola and Mateusz Plucinski and Zul Premji and Michael Ramharter and Caitlin L. Richmond and Lars Rombo and Cally Roper and Philip J. Rosenthal and Sam Salman and Albert Same-Ekobo and Carol Sibley and Sodiomon B. Sirima and Frank M. Smithuis and Fabrice A. Som\'{e} and Sarah G. Staedke and Peter Starzengruber and Nathalie Strub-Wourgaft and Inge Sutanto and Todd D. Swarthout and Din Syafruddin and Ambrose O. Talisuna and Walter R. Taylor and Emmanuel A. Temu and Julie I. Thwing and Halidou Tinto and Emiliana Tjitra and Offianan A. Tour\'{e} and T. Hien Tran and Johan Ursing and Innocent Valea and Giovanni Valentini and Michele Vugt and Lorenz Seidlein and Stephen A. Ward and Vincent Were and Nicholas J. White and Charles J. Woodrow and William Yavo and Adoke Yeka and Issaka Zongo and Julie A. Simpson and Philippe J. Guerin and Kasia Stepniewska and Ric N. Price},

url = {https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02265-9},

doi = {10.1186/s12916-022-02265-9},

issn = {1741-7015},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {BMC Medicine},

volume = {20},

issue = {1},

pages = {85},

abstract = {BACKGROUND Plasmodium falciparum malaria is associated with anaemia-related morbidity, attributable to host, parasite and drug factors. We quantified the haematological response following treatment of uncomplicated P. falciparum malaria to identify the factors associated with malarial anaemia. METHODS Individual patient data from eligible antimalarial efficacy studies of uncomplicated P. falciparum malaria, available through the WorldWide Antimalarial Resistance Network data repository prior to August 2015, were pooled using standardised methodology. The haematological response over time was quantified using a multivariable linear mixed effects model with nonlinear terms for time, and the model was then used to estimate the mean haemoglobin at day of nadir and day 7. Multivariable logistic regression quantified risk factors for moderately severe anaemia (haemoglobin \< 7 g/dL) at day 0, day 3 and day 7 as well as a fractional fall ≥ 25% at day 3 and day 7. RESULTS A total of 70,226 patients, recruited into 200 studies between 1991 and 2013, were included in the analysis: 50,859 (72.4%) enrolled in Africa, 18,451 (26.3%) in Asia and 916 (1.3%) in South America. The median haemoglobin concentration at presentation was 9.9 g/dL (range 5.0-19.7 g/dL) in Africa, 11.6 g/dL (range 5.0-20.0 g/dL) in Asia and 12.3 g/dL (range 6.9-17.9 g/dL) in South America. Moderately severe anaemia (Hb \< 7g/dl) was present in 8.4% (4284/50,859) of patients from Africa, 3.3% (606/18,451) from Asia and 0.1% (1/916) from South America. The nadir haemoglobin occurred on day 2 post treatment with a mean fall from baseline of 0.57 g/dL in Africa and 1.13 g/dL in Asia. Independent risk factors for moderately severe anaemia on day 7, in both Africa and Asia, included moderately severe anaemia at baseline (adjusted odds ratio (AOR) = 16.10 and AOR = 23.00, respectively), young age (age \< 1 compared to ≥ 12 years AOR = 12.81 and AOR = 6.79, respectively), high parasitaemia (AOR = 1.78 and AOR = 1.58, respectively) and delayed parasite clearance (AOR = 2.44 and AOR = 2.59, respectively). In Asia, patients treated with an artemisinin-based regimen were at significantly greater risk of moderately severe anaemia on day 7 compared to those treated with a non-artemisinin-based regimen (AOR = 2.06 [95%CI 1.39-3.05], p \< 0.001). CONCLUSIONS In patients with uncomplicated P. falciparum malaria, the nadir haemoglobin occurs 2 days after starting treatment. Although artemisinin-based treatments increase the rate of parasite clearance, in Asia they are associated with a greater risk of anaemia during recovery.},

keywords = {Antimalarials, Artemisinin-based therapy, Haemoglobin, Non-artemisinin-based therapy, Plasmodium falciparum, Pooled analysis of individual patient data, Severe anaemia},

pubstate = {published},

tppubtype = {article}

}