Exchange transfusion in children with severe falciparum malaria and heavy parasitaemia

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Preeti Shanbag1, Manisha Juvekar, Vaishali More

  • 1Paediatric Intensive Care Unit, Department of Paediatrics, Lokmanya Tilak Municipal Medical College & General Hospital, Mumbai, India. pshanbag@yahoo.com

Annals of Tropical Paediatrics
|August 24, 2006
PubMed

Insights

Exchange transfusion can be a life-saving adjunctive treatment for children with severe falciparum malaria and high parasite counts, especially when standard therapies fail. This procedure led to dramatic clinical improvement and full recovery in four pediatric cases.

Area of Science:

  • Pediatric Infectious Diseases
  • Hematology
  • Critical Care Medicine

Background:

  • Severe falciparum malaria poses a significant threat, particularly with heavy parasitaemia.
  • Exchange transfusion is recognized as an adjunctive therapy but its role in refractory cases is less understood.

Observation:

  • Four children with severe falciparum malaria, multi-system involvement, and high parasitaemia were treated with exchange transfusion.
  • These patients were critically ill despite receiving antimalarials and standard supportive care.

Findings:

  • All four children showed dramatic clinical improvement following exchange transfusion.
  • Complete clinical recovery was achieved in all patients post-procedure.
  • Patients received quinine, with one also receiving artesunate.

Implications:

  • Exchange transfusion may be a crucial intervention for severe, refractory falciparum malaria in children.
  • This procedure can lead to favorable outcomes in critically ill pediatric malaria patients.
  • Further research into the efficacy of exchange transfusion in severe malaria is warranted.

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