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Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 201...

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Autores principales: Boushab, Boushab Mohamed, Ould Ahmedou Salem, Mohamed Salem, Ould Mohamed Salem Boukhary, Ali, Parola, Philippe, Basco, Leonardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838900/
https://www.ncbi.nlm.nih.gov/pubmed/33375214
http://dx.doi.org/10.3390/tropicalmed6010001
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author Boushab, Boushab Mohamed
Ould Ahmedou Salem, Mohamed Salem
Ould Mohamed Salem Boukhary, Ali
Parola, Philippe
Basco, Leonardo
author_facet Boushab, Boushab Mohamed
Ould Ahmedou Salem, Mohamed Salem
Ould Mohamed Salem Boukhary, Ali
Parola, Philippe
Basco, Leonardo
author_sort Boushab, Boushab Mohamed
collection PubMed
description Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.
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spelling pubmed-78389002021-01-28 Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania Boushab, Boushab Mohamed Ould Ahmedou Salem, Mohamed Salem Ould Mohamed Salem Boukhary, Ali Parola, Philippe Basco, Leonardo Trop Med Infect Dis Article Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria. MDPI 2020-12-22 /pmc/articles/PMC7838900/ /pubmed/33375214 http://dx.doi.org/10.3390/tropicalmed6010001 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Boushab, Boushab Mohamed
Ould Ahmedou Salem, Mohamed Salem
Ould Mohamed Salem Boukhary, Ali
Parola, Philippe
Basco, Leonardo
Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania
title Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania
title_full Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania
title_fullStr Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania
title_full_unstemmed Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania
title_short Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania
title_sort clinical features and mortality associated with severe malaria in adults in southern mauritania
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838900/
https://www.ncbi.nlm.nih.gov/pubmed/33375214
http://dx.doi.org/10.3390/tropicalmed6010001
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