Abstract Ref Number = APCP949
OUTCOMES OF ARTEMETHER AND ARTESUNATE THERAPHY FOR PEDIATRIC CEREBRAL MALARIA IN UMBU RARA MEHA GENERAL HOSPITAL
Stevia Ariella Pasande,Erick Kristianto Adityatama,Sondang Panjaitan
RSUD Umbu Rara Meha Waingapu
Background : Cerebral malaria (CM) is the most severe neurological complication of infection with Plasmodium falciparum. The occurrence of CM reaches approximately 30-40% of total pediatric malaria events with the mortality rate around 15-22%. Thirty percent of total survivors develop permanent neurological sequelae. In 2017, there were 14 of 110 cases (12%) of pediatric malaria in Umbu Rara Meha General Hospital. Pediatric CM is treated with artesunate and artemether with diverse outcomes.
Case Presentation Summary : A descriptive retrospective study was conducted since January to December 2017. During this period, 10 children with CM were obtained. Five children were given artemether injection and others received artesunate injection. The patients were monitored for neurological deficits (level of consciousness, physiological and pathological reflexes, sensory and motor system examinations), length of stay, and parasite clearence time as outcome indicator. >From 5 patients given artesunate, 4 patients showed improvements in neurological deficits within the first day of therapy and a patient on the second day of therapy. The average length of stay was 4 days. Parasite clearance time were 2-4 days. Meanwhile, patients who received artemether exhibited relatively longer duration of neurological improvements as a patient showed improvement within 2 days of therapy, 2 patients within 3 days, and the rest after 4 days of therapy. parasite clearence time were longer, 2 patients on 4 days, 2 patients on 5 days and a patient on 6 days. The average length of stay was 6 days.
Learning Points/Discussion : Artesunate is better than arthemether as treatment of pediatric cerebral malaria, regards to the neurological improvements, parasite clearance time and length of stay.
Keywords: cerebral malaria artesunate artemether