Plasmodium falciparum hyperparasitaemia in children

The risk factors associated with hyperparasitemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 1,048 children enrolled prospectively in seven antimalarial drug trials between July 1996 and September 2003 in a hyperendemic area of southwestern Nigeri...

Full description

Bibliographic Details
Main Authors: Sowunmi A., Adedeji A.A., Fateye B.A., Babalola C.P.
Format: Article
Language:English
Published: EDP Sciences 2004-09-01
Series:Parasite
Subjects:
Online Access:http://dx.doi.org/10.1051/parasite/2004113317
_version_ 1827774838979166208
author Sowunmi A.
Adedeji A.A.
Fateye B.A.
Babalola C.P.
author_facet Sowunmi A.
Adedeji A.A.
Fateye B.A.
Babalola C.P.
author_sort Sowunmi A.
collection DOAJ
description The risk factors associated with hyperparasitemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 1,048 children enrolled prospectively in seven antimalarial drug trials between July 1996 and September 2003 in a hyperendemic area of southwestern Nigeria. The outcomes of treatment of hyperparasitaemia, and gametocyte carriage following treatment were also evaluated. The children were assigned to one of seven treatment groups : chloroquine (CQ) only ; pyrimethamine-sulfadoxine (PS) only; amodiaquine (AQ) only; CQ plus chlorpheniramine (CQCP); PS combined with CQ or AQ (COM); PS combined with probenecid (PPS); and halofantrine (HF). Hyperparasitaemia was found in 100 (9,5 %) of the 1,048 children at enrolment (day 0). Following oral therapy, 1.2 % of all patients (i.e. 13 patients) became hypeparasitaemic, which developed in all patients by day 1 of follow-up. In a multiple regression model, age ≤ 5 years, and a core temperature (oral or rectal) ≥ 39.5°C were found to be independent risk factors for hyperparasitaemia at enrolment. Following therapy, the cure rate on day 14 was significantly lower in those treated with CQ compared to other treatment groups. Severe resistance (RIII) response to treatment occurred significantly more frequently in those with hyperparasitaemia at enrolment than in those without, and was seen in five and one child with hyperparasitaemia who were treated with CQ and CQCP, respectively. Gametocyte carriage was insignificantly lower at enrolment and at all times following treatment in children with hyperparasitaemia than in age- and gender- matched children without hyperparasitaemia who received the same treatment. The results are discussed in the light of management of uncomplicated hyperparasitaemia in children in endemic settings.
first_indexed 2024-03-11T13:44:28Z
format Article
id doaj.art-acc7e77f0e094211bb6f05c1c3cf640c
institution Directory Open Access Journal
issn 1252-607X
1776-1042
language English
last_indexed 2024-03-11T13:44:28Z
publishDate 2004-09-01
publisher EDP Sciences
record_format Article
series Parasite
spelling doaj.art-acc7e77f0e094211bb6f05c1c3cf640c2023-11-02T11:01:42ZengEDP SciencesParasite1252-607X1776-10422004-09-0111331732310.1051/parasite/2004113317parasite2004113p317Plasmodium falciparum hyperparasitaemia in childrenSowunmi A.Adedeji A.A.Fateye B.A.Babalola C.P.The risk factors associated with hyperparasitemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 1,048 children enrolled prospectively in seven antimalarial drug trials between July 1996 and September 2003 in a hyperendemic area of southwestern Nigeria. The outcomes of treatment of hyperparasitaemia, and gametocyte carriage following treatment were also evaluated. The children were assigned to one of seven treatment groups : chloroquine (CQ) only ; pyrimethamine-sulfadoxine (PS) only; amodiaquine (AQ) only; CQ plus chlorpheniramine (CQCP); PS combined with CQ or AQ (COM); PS combined with probenecid (PPS); and halofantrine (HF). Hyperparasitaemia was found in 100 (9,5 %) of the 1,048 children at enrolment (day 0). Following oral therapy, 1.2 % of all patients (i.e. 13 patients) became hypeparasitaemic, which developed in all patients by day 1 of follow-up. In a multiple regression model, age ≤ 5 years, and a core temperature (oral or rectal) ≥ 39.5°C were found to be independent risk factors for hyperparasitaemia at enrolment. Following therapy, the cure rate on day 14 was significantly lower in those treated with CQ compared to other treatment groups. Severe resistance (RIII) response to treatment occurred significantly more frequently in those with hyperparasitaemia at enrolment than in those without, and was seen in five and one child with hyperparasitaemia who were treated with CQ and CQCP, respectively. Gametocyte carriage was insignificantly lower at enrolment and at all times following treatment in children with hyperparasitaemia than in age- and gender- matched children without hyperparasitaemia who received the same treatment. The results are discussed in the light of management of uncomplicated hyperparasitaemia in children in endemic settings.http://dx.doi.org/10.1051/parasite/2004113317malariahyperparasitaemiarisk factorsgametocytaemiachildrenNigeria
spellingShingle Sowunmi A.
Adedeji A.A.
Fateye B.A.
Babalola C.P.
Plasmodium falciparum hyperparasitaemia in children
Parasite
malaria
hyperparasitaemia
risk factors
gametocytaemia
children
Nigeria
title Plasmodium falciparum hyperparasitaemia in children
title_full Plasmodium falciparum hyperparasitaemia in children
title_fullStr Plasmodium falciparum hyperparasitaemia in children
title_full_unstemmed Plasmodium falciparum hyperparasitaemia in children
title_short Plasmodium falciparum hyperparasitaemia in children
title_sort plasmodium falciparum hyperparasitaemia in children
topic malaria
hyperparasitaemia
risk factors
gametocytaemia
children
Nigeria
url http://dx.doi.org/10.1051/parasite/2004113317
work_keys_str_mv AT sowunmia plasmodiumfalciparumhyperparasitaemiainchildren
AT adedejiaa plasmodiumfalciparumhyperparasitaemiainchildren
AT fateyeba plasmodiumfalciparumhyperparasitaemiainchildren
AT babalolacp plasmodiumfalciparumhyperparasitaemiainchildren