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Severe Allergic Reaction to Oral Artesunate-Amodiaquine Combination Treatment for Malaria: Case Report in the Democratic Republic of Congo

DOI: 10.4236/oalib.1103676, PP. 1-7

Subject Areas: Allergy & Clinical Immunology, Infectious Diseases

Keywords: Artesunate-Amodiaquine, Malaria, Adverse Event, Allergy, Case Report, Democratic Republic of Congo

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Abstract

Background: In 2012-2013, a pilot study on implementation of community-based case malaria management by trained community health workers was implemented in southern Katanga Province in the Democratic Republic of Congo (DRC). We report one case of severe adverse reaction that was linked to artesunate-amodiaquine (ASAQ). Case summary: An apparent healthy, 15-year-old Congolese female with a positive rapid diagnostic test for Plasmodium falciparum without any sign of complications was prescribed a fixed dose combination of ASAQ. Under direct observation, she took two tablets of ASAQ (200 mg AS/540mg AQ total) with water. Approximately 30 minutes later, she developed a generalized pruritus and widespread urticarial rash, with marked periorbital and forearm swelling. She was immediately referred to the nearest clinic. She did not present with fever or any respiratory distress and was fully conscious. She received dexamethasone 8 mg IV, followed 20 min later by 4 mg of chlorphenamine orally. Approximately 40 minutes after, the rash and swellings had mostly resolved. She received oral quinine as a second line treatment. Conclusion: This single presentation was the only such occurrence from 1354 malaria-infected patients. As ASAQ is the most widely used first-line treatment in the DRC, increased awareness and close monitoring of the use of this drug are advised. Health care professionals should document, report and provide immediate medical assistance.

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Swana, E. K. , Katshiza, C. , Luboya, O. N. and Bangs, M. J. (2017). Severe Allergic Reaction to Oral Artesunate-Amodiaquine Combination Treatment for Malaria: Case Report in the Democratic Republic of Congo. Open Access Library Journal, 4, e3676. doi: http://dx.doi.org/10.4236/oalib.1103676.

References

[1]  World Health Organization (2010) Guidelines for the Treatment of Malaria. 2nd Edition, WHO, Geneva.
[2]  Ruizendaal, E., Dierickx, S., Grietens, K.P., Schallig, H.D., et al. (2014) Success or Failure of Critical Steps in Community Case Management of Malaria with Rapid Diagnostic Tests: A Systematic Review. Malaria Journal, 13, 229.
https://doi.org/10.1186/1475-2875-13-229
[3]  Ribeiro, I.R. and Olliaro, P. (1998) Safety of Artemisinin and Its Derivatives. A Review of Published and Unpublished Clinical Trials. Médecine Tropicale, 58, 50-53.
[4]  Price, R., Vugt, V., Phaipun, L., Luxemburger, C., et al. (1999) Adverse Effects in Patients with Acute Falciparum Malaria Treated with Artemisinin Derivatives. The American Journal of Tropical Medicine and Hygiene, 60, 547-555.
https://doi.org/10.4269/ajtmh.1999.60.547
[5]  Taylor, W.R. and White, N.J. (2004) Antimalarial Drug Toxicity: A Review. Drug Safety, 27, 25-61.
https://doi.org/10.2165/00002018-200427010-00003
[6]  Swana, E.K., Makan, G.Y., Mukeng, C.K., Mupumba, H.I., Kalaba, G.M., Luboya, O.N. and Bangs, M.J. (2016) Feasibility and Implementation of Community-Based Malaria Case Management with Integrated Vector Control in the Democratic Republic of Congo. Malaria Journal, 15, 413.
https://doi.org/10.1186/s12936-016-1475-3
[7]  Adjuik, M., Agnamey, P., Babiker, A., Borrman, S., et al. (2002) Amodiaquine-Arte- sunate versus Amodiaquine for Uncomplicated Plasmodium falciparum Malaria in African Children: A Randomised, Multicentre Trial. Lancet, 359, 1365-1372.
https://doi.org/10.1016/S0140-6736(02)08348-4
[8]  Olliaro, P., Nevill, C., LeBras, J., Ringwald, P., et al. (1996) Systematic Review of Amodiaquine Treatment in Uncomplicated Malaria. Lancet, 348, 1196-1201.
https://doi.org/10.1016/S0140-6736(96)06217-4
[9]  Hatton, C.S.R., Peto, T.E.A., Bunch, C. and Pasvol, G. (1986) Frequency of Severe Neutropenia Associated with Amodiaquine Prophylaxis against Malaria. Lancet, 1, 411-414.
https://doi.org/10.1016/S0140-6736(86)92371-8
[10]  Leonardi, E., Gilvary, G., White, N.J. and Nosten, F. (2001) Severe Allergic Reactions to Oral Artesunate: A Report of Two Cases. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95, 182-183.
https://doi.org/10.1016/S0035-9203(01)90157-9
[11]  Ndounga, M., Mayengue, P.I., Casimiro, P.N., Koukouikila-Koussounda, F., et al. (2015) Artesunate-Amodiaquine versus Artemether-Lumefantrine for the Treatment of Acute Uncomplicated Malaria in Congolese Children under 10 Years Old Living in a Suburban Area: A Randomized Study. Malaria Journal, 14, 423.
https://doi.org/10.1186/s12936-015-0918-6
[12]  Onyamboko, M.A., Fanello, C.I., Wongsaen, K., Tarning, J., et al. (2014) Randomized Comparison of the Efficacies and Tolerabilities of Three Artemisinin-Based Combination Treatments for Children with Acute Plasmodium falciparum Malaria in the Democratic Republic of the Congo. Antimicrobial Agents and Chemotherapy, 58, 5528-5536.
[13]  Egunsola, O. and Oshikoya, K. (2013) Comparative Safety of Artemether-Lume- fantrine and Other Artemisinin-Based Combinations in Children: A Systematic Review. Malaria Journal, 12, 385.
https://doi.org/10.1186/1475-2875-12-385
[14]  Dodoo, A.N.O., Fogg, C., Nartey, E.T., Ferreira, G.L.C., et al. (2014) Profile of Adverse Events in Patients Receiving Treatment for Malaria in Urban Ghana: A Cohort-Event Monitoring study. Drug Safety, 6, 433-448.
https://doi.org/10.1007/s40264-014-0164-9
[15]  Ndounga, M., Mayengue, P.I., Casimiro, P.N., Loumouamou, D., et al. (2013) Artesunate-Amodiaquine Efficacy in Congolese Children with Acute Uncomplicated Falciparum Malaria in Brazzaville. Malaria Journal, 12, 53.

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