Intermittent preventive therapy for malaria with monthly artemether–lumefantrine for the post-discharge management of severe anaemia in children aged 4–59 months in southern Malawi: a multicentre, randomised, placebo-controlled trial

Phiri, Kamija S.; Esan, Michael; Hensbroek, Michaël Boele van; Khairallah, Carole; Faragher, Brian; Kuile, Feiko O. ter

doi:10.1016/s1473-3099(11)70320-6

Cited by 56 publications

(89 citation statements)

References 36 publications

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“…A complementary analysis in a subsample of SAM and non-SAM children matched by age retrieved similar HRs around 2, suggesting that SAM would be associated with an increased risk of reinfection until day 28 regardless of the confounding effect of age. The limited duration of this higher-risk period (which did not remain at day 42) is compatible with a lack of post-treatment prophylactic effect of AL after 28 days [32]. The significantly slower hematological recovery in SAM children is probably mostly due to the effect of nutritional deficiencies on hematopoiesis; this difference was observed considering that all SAM and a majority of non-SAM children received iron and folic acid supplementation.…”

Section: Discussionmentioning

confidence: 91%

Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger

Denoeud-Ndam¹,

Dicko

Baudin³

et al. 2016

BMC Med

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Section: Discussionmentioning

confidence: 91%

Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger

Denoeud-Ndam¹,

Dicko

Baudin³

et al. 2016

BMC Med

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“…Thirteen studies met both inclusion and exclusion criteria and were included in the final analysis; four randomized controlled trials [3], [4], [9], [10], four prospective cohort studies [1], [11]–[13], three retrospective cohort studies [14]–[16], and two case-control studies with longitudinal follow-up of cases and/or controls [2], [17] ( Figure 1 ). No studies were excluded based on language of publication.…”

Section: Resultsmentioning

confidence: 99%

Pediatric Post-Discharge Mortality in Resource Poor Countries: A Systematic Review

et al. 2013

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ObjectivesMortality following hospital discharge is an important and under-recognized contributor to overall child mortality in developing countries. The primary objective of this systematic review was to identify all studies reporting post-discharge mortality in children, estimate likelihood of death, and determine the most important risk factors for death.Search StrategyMEDLINE and EMBASE were systematically searched using MeSH terms and keywords from the inception date to October, 2012. Key word searches using Google Scholar™ and hand searching of references of retrieved articles was also performed. Studies from developing countries reporting mortality following hospital discharge among a pediatric population were considered for inclusion.ResultsThirteen studies that reported mortality rates following discharge were identified. Studies varied significantly according to design, underlying characteristics of study population and duration of follow-up. Mortality rates following discharge varied significantly between studies (1%–18%). When reported, post-discharge mortality rates often exceeded in-hospital mortality rates. The most important baseline variables associated with post-discharge mortality were young age, malnutrition, multiple previous hospitalizations, HIV infection and pneumonia. Most post-discharge deaths occurred early during the post-discharge period. Follow-up care was examined in only one study examining malaria prophylaxis in children discharged following an admission secondary to malaria, which showed no significant benefit on post-discharge mortality.ConclusionsThe months following hospital discharge carry significant risk for morbidity and mortality. While several characteristics are strongly associated with post-discharge mortality, no validated tools are available to aid health workers or policy makers in the systematic identification of children at high risk of post-discharge mortality. Future research must focus on both the creation of tools to aid in defining groups of children most likely to benefit from post-discharge interventions, and formal assessment of the effectiveness of such interventions in reducing morbidity and mortality in the first few months following hospital discharge.

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“…Zinc may also play a role in post-discharge morbidity and mortality from sepsis secondary to malaria, pneumonia, and diarrhea because these conditions, especially pneumonia and diarrhea, are thought to benefit from treatment with zinc 27. Another study investigated the use of post-discharge intermittent prophylactic therapy for malaria in children with severe anemia, and found a 26% reduction in the composite endpoint of readmission or death within 6 months 28. More studies are needed to determine the effect, if any, on mortality after discharge in this population.…”

Section: Possible Pragmatic Alternativesmentioning

confidence: 99%

Pediatric sepsis in the developing world: challenges in defining sepsis and issues in post-discharge mortality

Wiens¹,

Kumbakumba²,

Kissoon³

et al. 2012

CLEP

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Sepsis represents the progressive underlying inflammatory pathway secondary to any infectious illness, and ultimately is responsible for most infectious disease-related deaths. Addressing issues related to sepsis has been recognized as an important step towards reducing morbidity and mortality in developing countries, where the majority of the 7.5 million annual deaths in children under 5 years of age are considered to be secondary to sepsis. However, despite its prevalence, sepsis is largely neglected. Application of sepsis definitions created for use in resource-rich countries are neither practical nor feasible in most developing country settings, and alternative definitions designed for use in these settings need to be established. It has also been recognized that the inflammatory state created by sepsis increases the risk of post-discharge morbidity and mortality in developed countries, but exploration of this issue in developing countries is lacking. Research is urgently required to characterize better this potentially important issue.

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Intermittent preventive therapy for malaria with monthly artemether–lumefantrine for the post-discharge management of severe anaemia in children aged 4–59 months in southern Malawi: a multicentre, randomised, placebo-controlled trial

Cited by 56 publications

References 36 publications

Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger

Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger

Pediatric Post-Discharge Mortality in Resource Poor Countries: A Systematic Review

Pediatric sepsis in the developing world: challenges in defining sepsis and issues in post-discharge mortality

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