Anemia and transfusion requirements among Ugandan children with severe malaria treated with intravenous artesunate

Parenteral artesunate for the treatment of severe malaria in non-immune travelers is associated with late-onset hemolysis. In children in sub-Saharan Africa, the hematologic effects of malaria and artesunate are less well documented. Here we report a prospective case series of 91 children with severe malaria treated with parenteral artesunate, managed at a resource-poor hospital in Africa, with longitudinal data on hemoglobin (Hb), lactate dehydrogenase (LDH), haptoglobin, and erythrocyte morphology. The median (range) age was 2 (1–8) years and 43 (47%) were female. The median (IQR) admission Hb level was 69 (55–78) g/L and 20 patients (22%) had severe malarial anemia (Hb