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[Severe malaria in Black Africa].

J M Saissy1, M Vitris, F Cellard-Peyle

  • 1Service d'anesthésie-réanimation, Hopital Principal, Dakar, Sénégal.

Dakar Medical
|January 1, 1991
PubMed
Summary

Severe malaria, caused by Plasmodium falciparum, presents differently in children and adults. Treatment involves quinine and supportive care, with varying recovery outcomes and potential long-term effects.

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Area of Science:

  • Tropical medicine
  • Infectious diseases
  • Parasitology

Context:

  • Severe and complicated malaria is a life-threatening Plasmodium falciparum infection.
  • Clinical presentation and outcomes differ significantly between pediatric and adult patients.
  • Cerebral malaria in children involves coma and seizures, while adults may experience multi-organ failure.

Purpose:

  • To differentiate the clinical presentation and management of severe malaria in children versus adults.
  • To outline the recommended treatment protocols for severe malaria.
  • To describe the typical recovery patterns and potential complications in different age groups.

Summary:

  • Severe malaria in children often presents as cerebral malaria with coma and convulsions, while adults may develop multi-organ failure with less impaired consciousness.
  • Treatment necessitates quinine with a loading dose, followed by maintenance doses for 7 days, alongside essential symptomatic therapies like artificial ventilation.
  • Pediatric recovery is generally favorable, though neurological sequelae can occur. Adult cases frequently involve complications such as pulmonary edema, worsening coma, and nosocomial infections, sometimes leading to late-onset multi-organ failure.

Impact:

  • Highlights critical differences in severe malaria presentation and prognosis between children and adults.
  • Emphasizes the importance of prompt and appropriate treatment with quinine and supportive care.
  • Underscores the risk of neurological sequelae in children and severe complications, including multi-organ failure, in adults.

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