New: Haematology Study Group

A pooled analysis of haematological response before and after treatment of Plasmodium falciparum malaria

Malaria infection is associated with a drop in haemoglobin levels in the blood, which can often result in anaemia. However, little is known about what affect artemisinin-based combination therapies (ACTs) - the standard treatment for Plasmodium falciparum malaria - can have on haemoglobin levels and malaria-related anaemia.

Malaria-associated anaemia is a complex phenomenon and different ACTs may produce a different response to anaemia. Although some recent studies have described differences in haemoglobin levels during recovery after treatment with different ACTs, the full scope of changes in haemoglobin levels over the course of ACT treatment has not been widely assessed.

To broaden our understanding of this issue, WWARN partners have set up a new haematology study group. This group aims to understand what is the normal haematological response and recovery in patients following the treatment of uncomplicated falciparum malaria.

“Malaria-related anaemia is a significant problem in malaria endemic regions such as Uganda, Mali, and Madagascar, and we simply don’t understand how our current first-line treatment against malaria is affecting the problem,” says Prof Ric Price, WWARN Clinical Group Head and co-lead of this study group. “This group will provide evidence as to which ACTs should be administered to people most at risk of anaemia during malaria infection including young children and pregnant women.”

The goal of this study group is to create a single database of quality-assured individual patient data in order to quantify:

• the risks and benefits of different treatment options of both the ACT and other antimalarials such as single dose primaquine 

• the reduction in haemoglobin associated with acute uncomplicated malaria before and after treatment

And to assess: 

• the factors associated with anaemia at start of treatment and the development of anaemia during follow-up phase

• the time for an haematological recovery after administration of different ACTs

The study group will be co-led by research partners; Prof Ric Price, Clinical Group Head, Dr Christian Nsanzabana, Clinical Scientific Coordinator, and Dr Kasia Stepniewska, Head of Statistics at WWARN.

Data sets from over 100 studies and 70,000 malaria patients with haematology information have been contributed to the WWARN Data Centre so far, but more studies with haematological data are needed. Read more about the analysis and governance proposal and how to join this group. For further information, email the team: clinical@wwarn.org