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Imported falciparum malaria among adults requiring intensive care: analysis of the literature
BACKGROUND: Malaria 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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015364/ https://www.ncbi.nlm.nih.gov/pubmed/24602328 http://dx.doi.org/10.1186/1475-2875-13-79 |
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author | Marks, Michael Armstrong, Margaret Walker, David Doherty, Tom |
author_facet | Marks, Michael Armstrong, Margaret Walker, David Doherty, Tom |
author_sort | Marks, Michael |
collection | PubMed |
description | BACKGROUND: Malaria 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. METHODS: PubMed 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. RESULTS: Thirteen 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%. CONCLUSIONS: Many 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. |
format | Online Article Text |
id | pubmed-4015364 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-40153642014-05-10 Imported falciparum malaria among adults requiring intensive care: analysis of the literature Marks, Michael Armstrong, Margaret Walker, David Doherty, Tom Malar J Research BACKGROUND: Malaria 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. METHODS: PubMed 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. RESULTS: Thirteen 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%. CONCLUSIONS: Many 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. BioMed Central 2014-03-05 /pmc/articles/PMC4015364/ /pubmed/24602328 http://dx.doi.org/10.1186/1475-2875-13-79 Text en Copyright © 2014 Marks et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Marks, Michael Armstrong, Margaret Walker, David Doherty, Tom Imported falciparum malaria among adults requiring intensive care: analysis of the literature |
title | Imported falciparum malaria among adults requiring intensive care: analysis of the literature |
title_full | Imported falciparum malaria among adults requiring intensive care: analysis of the literature |
title_fullStr | Imported falciparum malaria among adults requiring intensive care: analysis of the literature |
title_full_unstemmed | Imported falciparum malaria among adults requiring intensive care: analysis of the literature |
title_short | Imported falciparum malaria among adults requiring intensive care: analysis of the literature |
title_sort | imported falciparum malaria among adults requiring intensive care: analysis of the literature |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015364/ https://www.ncbi.nlm.nih.gov/pubmed/24602328 http://dx.doi.org/10.1186/1475-2875-13-79 |
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