Community management of anti-malarials in Africa and iatrogenic risk.

Abstract:

:Distribution of anti-malarials at the community level is one of the interventions recommended to reduce mortality from febrile illnesses. Inappropriate treatment of fever with anti-malarials may result in missed diagnosis and delays in appropriate treatments including consideration of other illnesses than malaria. We report the case of an 8-year-old black girl receiving prophylaxis with sulfadoxine-pyrimethamine from the caretaker of the community during her holidays in Ivory Coast. A persistent fever suspected to be due to malaria was treated inappropriately with atovaquone-proguanil and then with sulfadoxine-pyrimethamine again. Cumulative toxicity of anti-malarials leads to irreversible hepatic damages requiring hepatic transplantation. Community caretakers must be aware of the potential side effects and the contraindications of anti-malarials. Early identification of drug-induced toxicity and immediate discontinuation of the drug are the more effective tools to limit the progression of tissue damage.

journal_name

J Trop Pediatr

authors

Orostegui L,Balu L,Chevret L,Habes D,Pussard E

doi

10.1093/tropej/fmq074

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

225-6

issue

3

eissn

0142-6338

issn

1465-3664

pii

fmq074

journal_volume

57

pub_type

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