[Antimalaria therapy of chronic renal failure]

The treatment of uncoded malaria (malaria) remains very delicate in chronic renal failure which is associated with immunity abnormalities which weaken the uremic subject and create a vicious morbid circle.

Describe the malaria treatment profile of the chronic renal failure patient with malaria.

This was a retrospective study of patients with chronic renal failure presenting with diagnosed simple malaria admitted to the nephrology departments of the university hospital centers of Treichville and Yopougon from October 1, 2018 to February 28, 2019 and having given their informed consent verbal.

We identified 278 chronic renal failure patients, 40 (14.4%) of whom had malaria. The mean age was 42±13 years with a male predominance (sex-ratio: 1.1). The clinical signs were hyperthermia (70%), diffuse pain (67.5%) and headache (37.5%). Chronic renal failure was discovered at stage 5 in 87.5% of cases and 85% started chronic dialysis using a dialysis using a hemodialysis catheter (94%). Malaria was confirmed by a thick drop (66%) and a Quantitative Buffy Coast Malaria Test (44%). There was severe anemia with an average hemoglobin level of 7.1±1.9g/dL and thrombocytopenia (38.4%). Malaria was first treated with artemether (67%) or artesunate (25%) intramuscularly (67.5%) or intravenously (25%). The average duration of treatment with artemether was 3 days and artesunate 4.5 days±1.1. Seventy-eight percent of the patients had an injectable antimalarial without oral relay. The clinical course was favorable in 77%. Diabetes was a factor influencing patient evolution.

This study reveals a misuse of antimalarials because the national recommendations for the treatment of malaria were not respected. The presence of anemia would make the parenteral routes preferable.