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[Severe malaria in intensive care units in 2003]
J M Saïssy1, B Rouvin, P Koulmann
1jmsaissy@aol.com
Medecine Tropicale : Revue Du Corps De Sante Colonial
|October 29, 2003
Summary
Severe malaria, often caused by Plasmodium falciparum, leads to organ failure and metabolic issues. Intensive care improves outcomes, but mortality remains high, especially in children in endemic areas.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Critical Care
Context:
- Severe malaria presents with multi-organ failure and metabolic disturbances, particularly in non-immune adults.
- Complications like pulmonary edema, jaundice, and renal insufficiency are common, while acidosis indicates a poor prognosis.
- Pregnant women and children in endemic areas face unique risks, including hypoglycemia and cerebral malaria.
Purpose:
- To outline the clinical characteristics and management of severe malaria requiring intensive care.
- To highlight prognostic factors and specific challenges in vulnerable populations.
- To review current treatment guidelines and supportive care measures.
Summary:
- Severe malaria is defined by organ system failure and metabolic derangements due to Plasmodium falciparum.
- Key complications include altered mental status, pulmonary edema, jaundice, and potential hypoglycemia with quinine treatment.
- Treatment involves quinine or artemether for resistant strains, alongside intensive supportive care like mechanical ventilation and dialysis.
Impact:
- Intensive care management reduces mortality for severe imported malaria to 10-30%.
- Access to intensive care facilities is critical, particularly for children in malaria-endemic regions, where over 90% of deaths occur.
- Understanding these complications and treatment protocols is vital for improving patient outcomes and reducing malaria-related mortality.