[Artesunate and severe malaria in paediatrics]

Area of Science:

• Infectious Diseases
• Tropical Medicine
• Pharmacology

Background:

• Malaria remains a significant threat, particularly to non-immune populations like young children.
• Imported malaria cases, though rare in Europe, are increasing due to global travel.
• Severe malaria contributes to high pediatric mortality in resource-limited settings.

Purpose of the Study:

• To review the current recommendations for severe malaria treatment.
• To highlight the efficacy of artesunate as a first-line therapy.
• To discuss challenges in artesunate implementation and potential side effects.

Main Methods:

• Review of World Health Organization (WHO) guidelines and clinical studies.
• Analysis of treatment protocols for severe malaria in adults and children.
• Examination of post-treatment adverse events, specifically delayed post-artesunate hemolytic anemia (PADH).

Main Results:

• Artesunate is recommended by the WHO as the first-line treatment for severe malaria since 2010.
• Artesunate has demonstrated a significant reduction in mortality rates associated with severe malaria.
• Delayed post-artesunate hemolytic anemia (PADH) is a recognized side effect requiring hematological monitoring.

Conclusions:

• Artesunate is the preferred parenteral antimalarial for severe malaria in both adults and children.
• Barriers such as availability and cost impede widespread artesunate adoption in Europe.
• Vigilant hematological monitoring is essential to manage the risk of PADH in patients treated with artesunate.