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Hematologic changes in acute and convalescent uncomplicated Plasmodium falciparum malaria have not been well studied, particularly in young children in Africa. Hematologic data were obtained for 3,044 children less than five years of age in seven randomized controlled trials at 14 sites. Using paired analysis between day 28 and baseline in patients without parasitologic failure as a proxy for malaria-induced effects, we found a statistically significant but clinically modest increase in leukocyte counts (5%) resulting from a larger increase in neutrophils (43%) than the decrease in lymphocytes counts (-16%); levels of hemoglobin and platelets decreased (-13% and -49%, respectively). Multivariate random effects analysis showed trends during follow-up (increased levels of hemoglobin, platelets and lymphocytes, and decreased levels of leukocytes and neutrophils) and identified explanatory variables. The risk of neutropenia increased with follow-up time independent of treatment outcome, and was lower with age, higher baseline parasitemia, and artemisinin combination treatment. These analyses provides information on hematologic variations caused by malaria.

Original publication

DOI

10.4269/ajtmh.2011.11-0154

Type

Journal article

Journal

The American journal of tropical medicine and hygiene

Publication Date

10/2011

Volume

85

Pages

619 - 625

Addresses

United Nations Children's Fund/United Nations Development Program/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland. olliarop@who.int

Keywords

Humans, Malaria, Falciparum, Child, Africa South of the Sahara