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Malaria chemoprevention in the postdischarge management of severe anemia

New England Journal of Medicine Dec 11, 2020

Kwambai TK, Dhabangi A, Idro R, et al. - In view of a high risk of readmission and death within 6 months post-discharge in children who have been hospitalized with severe anemia in regions of Africa, wherein malaria is endemic, researchers investigated if 3 months of malaria chemoprevention could decrease morbidity as well as death following hospital discharge in children younger than 5 years of age who had been admitted with severe anemia. This multicenter, two-group, randomized, placebo-controlled trial was carried out in nine hospitals in Kenya and Uganda. Two weeks post-discharge, children were randomized to receive dihydroartemisinin–piperaquine (chemoprevention group) or placebo, given as 3-day courses at 2, 6, and 10 weeks following discharge. Findings revealed that 3 months of postdischarge malaria chemoprevention with monthly dihydroartemisinin–piperaquine vs placebo conferred prevention of more deaths or readmissions for any reason post-discharge among children who had recently received treatment for severe anemia, in areas with intense malaria transmission.

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