[Antimalaria therapy of chronic renal failure].

Abstract

INTRODUCTION\nThe treatment of uncoded malaria (malaria) remains very delicate in chronic renal failure which is associated with immunity abnormalities which weaken the uremic subject and create a vicious morbid circle.\n\n\nOBJECTIVE\nDescribe the malaria treatment profile of the chronic renal failure patient with malaria.\n\n\nMETHODOLOGY\nThis was a retrospective study of patients with chronic renal failure presenting with diagnosed simple malaria admitted to the nephrology departments of the university hospital centers of Treichville and Yopougon from October\xa01, 2018 to February\xa028, 2019 and having given their informed consent verbal.\n\n\nRESULTS\nWe identified 278\xa0chronic renal failure patients, 40 (14.4%) of whom had malaria. The mean age was 42±13\xa0years with a male predominance (sex-ratio: 1.1). The clinical signs were hyperthermia (70%), diffuse pain (67.5%) and headache (37.5%). Chronic renal failure was discovered at stage\xa05 in 87.5% of cases and 85% started chronic dialysis using a dialysis using a hemodialysis catheter (94%). Malaria was confirmed by a thick drop (66%) and a Quantitative Buffy Coast Malaria Test (44%). There was severe anemia with an average hemoglobin level of 7.1±1.9g/dL and thrombocytopenia (38.4%). Malaria was first treated with artemether (67%) or artesunate (25%) intramuscularly (67.5%) or intravenously (25%). The average duration of treatment with artemether was 3\xa0days and artesunate 4.5\xa0days±1.1. Seventy-eight percent of the patients had an injectable antimalarial without oral relay. The clinical course was favorable in 77%. Diabetes was a factor influencing patient evolution.\n\n\nCONCLUSION\nThis study reveals a misuse of antimalarials because the national recommendations for the treatment of malaria were not respected. The presence of anemia would make the parenteral routes preferable.