Malaria in severe cases can result in death and requires treatment with intravenous articulate (IVAS). The Centers for Disease Control and Prevention provided IVAS starting 1 April 2019 for all patients with severe malaria in the United States. A study described the safety and effectiveness of IVAS in severe patients. Patients who matched the criteria for severe malaria from April 2019 to December 2020 who received IVAS were included. Demographic, clinical, laboratory, adverse event, and outcome information were collected for the studies. Proportions, medians, interquartile range (IQR), and tests of significance were used to describe the clinical presentation, time to reach 1% and 0% parasitemia, call mom Edwards events, and death for differences in proportion.
Out of 280 patients, the majority were male (61.4%), black (75.0%), With a median age of 35 (IQR: 15.8-53.9). Most were detected with the word Plasmodium falciparum (83.6%) with a median parasitemia of 8.0% (IQR: 4.6-13.2). Of 170 patients with information, 159 (93.5%) reached less than or equal to 1% parasitemia by the third IVAS dose with a median time of 17.6 hours (IQR: 10.8-28.8), and 0% parasitemia in a median of 37.2 hours (IQR 27.3-55.2). Patients having parasite densities of more than 10% and those in need of adjunct therapy had significantly higher parasite clearance times. Adverse events connected with Ivy were reported in 4.8%. 8 patients had post- artesunate delayed hemolysis that resolved. There were 5( 1.8%) deaths all attributable to severe malaria.
IVAS came out as a safe and effective drug for the treatment of severe malaria in the United States, and hence timely administration can be lifesaving.
Reference:academic.oup.com/cid/article/73/11/1965/6329244
