Trends in Imported Malaria to Basel, Switzerland: Table 1

Thierfelder, Clara; Schill, Catherine; Hatz, Christoph; Nüesch, Reto

doi:10.1111/j.1708-8305.2008.00251.x

Cited by 15 publications

(14 citation statements)

References 7 publications

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“…In this series, only one death occurred at a time when there was evidence of active malarial infection and the other four resulted from complications associated with intensive care, such as cardiac arrhythmia or nosocomial infection. Previous studies have reported a mortality rate between seven and 25% [5-11]. Recent data from the Malaria Reference Laboratory have shown a marked geographical variation in mortality from imported malaria from different parts of the UK [23].…”

Section: Discussionmentioning

confidence: 99%

“…The case fatality rate for P . falciparum in the UK is less than 1% but in previous series the mortality rate for those patients requiring admission to an intensive care unit (ICU) as a result of malaria has varied from 7% to 25% [5-11]. Most data on severe malaria come from endemic countries.…”

Section: Introductionmentioning

confidence: 99%

“…Earlier reports of severe imported malaria have shown that cerebral malaria, adult respiratory distress syndrome (ARDS) and acute kidney injury (AKI) are the most common complications of malaria requiring admission to ICU [5-11]. The inclusion criteria for these studies have varied; some included patients with non-severe malaria admitted to ICU while others included all patients with malaria who met at least one of the World Health Organisation’s (WHO) criteria for severe disease [14] regardless of whether or not they were admitted to ICU.…”

Section: Introductionmentioning

confidence: 99%

“…Only two papers [5,6] have included data on the rates of bacterial co-infection. None of these earlier studies have included patients treated with Artemisinin-based therapy and in only one study [11] were exchange transfusions used. Data on any long term sequelae following severe imported malaria are also scarce.…”

Section: Introductionmentioning

confidence: 99%

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Severe imported falciparum malaria among adults requiring intensive care: a retrospective study at the hospital for tropical diseases, London

et al. 2013

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BackgroundMalaria is the commonest imported infection in the UK. Malaria requiring ICU admission has a reported mortality of up to 25%. The relationship between ethnicity, immunity, and risk of malaria is complex. The Malaria Score for Adults (MSA) and Coma Acidosis Malaria (CAM) score have recently been proposed to risk stratify patients with malaria.MethodsRetrospective study of patients with WHO severe falciparum malaria admitted to ICU at the Hospital for Tropical Diseases, London, UK. The relationship between clinical variables and risk of death or a prolonged ICU stay were examined with logistic regression. The predictive value of the MSA and CAM score were calculated.Results124 patients were included. Cerebral malaria and acute kidney injury occurred earlier (median day 1) than acute respiratory distress syndrome (median day 3). Six patients had community acquired bacterial co-infection. Eight patients were co-infected with HIV, five of whom were newly diagnosed. The positive predictive value of a CAM score ≥2 or an MSA ≥5 for death were 12% and 22% respectively. Five patients died. No variable was significantly associated with risk of death. There were no significant differences between individuals raised in endemic countries compared to non-endemic countries.ConclusionsMortality in patients managed in a specialist centre was low. Patients who died succumbed to complications associated with a prolonged stay on ICU rather than malaria per se. The clinical usefulness of the MSA and CAM score was limited. Co-infection with HIV was relatively common but compared to studies in children, bacteraemia was uncommon. The relationship between ethnicity and immunity to severe disease is complex.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Severe imported falciparum malaria among adults requiring intensive care: a retrospective study at the hospital for tropical diseases, London

et al. 2013

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“…The literature search identified 61 papers, 13 of which were included (Figure 1) [1,4-15]. Forty-eight were excluded; 22 were not published in English, 11 were not primary research articles, four reported only on paediatric cases and 11 were short case series that included fewer than ten patients.…”

Section: Resultsmentioning

confidence: 99%

Imported falciparum malaria among adults requiring intensive care: analysis of the literature

Marks

Armstrong

Walker

et al. 2014

Malar J

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BackgroundMalaria is the most important imported tropical disease. Infection with Plasmodium falciparum is responsible for most of the morbidity and mortality. There are differences in both the epidemiology of imported malaria and in the facilities available to treat travellers with severe malaria between different parts of the world. There are limited data to guide clinicians caring for adults with imported malaria in an intensive care unit (ICU). Available data from the English-speaking literature concerning such patients was reviewed.MethodsPubMed was searched for studies on adults with imported malaria treated in an ICU. Data were extracted on the epidemiology, management, rates of concomitant community-acquired bacterial infection and outcomes.ResultsThirteen studies were identified, which between them included 1,001 patients over more than 40 years. Forty-one per cent were born and often still resident in an endemic country and were assumed to have at least partial immunity to the disease. Acute kidney injury (AKI) (36%), acute respiratory distress syndrome (ARDS) (31%) and impaired consciousness (25%) were common. Hyperparasitaemia (more than 2%) was seen in 57%. Thirty-four per cent required mechanical ventilation and 22% required renal replacement therapy. Community-acquired bacterial co-infection was seen in 8%; 2% had gram-negative bacteraemia at admission. Overall the case fatality rate was 9%.ConclusionsMany patients who require admission to ICU were originally from malaria-endemic countries and many did not have hyperparasitaemia. Gram-negative bacteraemia was uncommon among adults with severe malaria. The case fatality rate remains high; however, improvements in ICU care and increasing use of artemisinins may reduce this in the future.

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Paludisme chez les migrants, expérience d’un hôpital parisien (2006–2010)

Develoux

Loup

Dautheville

et al. 2012

Bull. Soc. Pathol. Exot.

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In recent days immigrants represent the main risk group for imported malaria in northern countries. Most of them are migrants returning to their country of origin to visit friends and relatives (VFR). We retrospectively examined the main clinical, biological, and therapeutic data of all malaria cases in immigrants from 2006 to 2010 in Tenon hospital, Paris. The hospital is situated in a Paris district with an important African community. During the study period 239 imported malaria cases were observed in adults of which 199 were immigrants, 186 VFR, and 13 recently arrived. Most cases were from sub-Saharan Africa and Comoro islands. Chimioprophylaxis was not taken in 81.2% of VFR. It was inadequate in 43.7% and not taken correctly in 84.4%. Plasmodium falciparum was the most frequent species identified: 190/199 (95.5%). Severe P. falciparum malaria was observed in 25 cases (13.2%); two of them were recently arrived. One patient, African VFR, died. In this series two high-risk groups were represented: HIV-infected patients and pregnant women. Six of the HIV patients had severe malaria and all pregnant women had anemia. Our results are similar to those observed recently in other European countries. Mean age of VFR is increasing and the risk for severe P. falciparum malaria became identical to the one observed in non-immune travelers. Protection measures remain still insufficient in this population of travelers.

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Trends in Imported Malaria to Basel, Switzerland: Table 1

Cited by 15 publications

References 7 publications

Severe imported falciparum malaria among adults requiring intensive care: a retrospective study at the hospital for tropical diseases, London

Severe imported falciparum malaria among adults requiring intensive care: a retrospective study at the hospital for tropical diseases, London

Imported falciparum malaria among adults requiring intensive care: analysis of the literature

Paludisme chez les migrants, expérience d’un hôpital parisien (2006–2010)

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