Retrospective study of imported falciparum malaria in French paediatric intensive care units.
Arch Dis Child
; 101(11): 1004-1009, 2016 Nov.
Article
em En
| MEDLINE
| ID: mdl-27281455
ABSTRACT
OBJECTIVE:
The World Health Organization (WHO) severity criteria for paediatric Plasmodium falciparum (Pf) malaria are based on studies in countries of endemic malaria. The relevance of these criteria for other countries remains unclear. We assessed the relevance of these criteria in an industrialised country.DESIGN:
Retrospective case-control study.SETTING:
Eight French university hospitals, from 2006 to 2012. PATIENTS Children with Pf malaria admitted to paediatric intensive care units (cases n=55) or paediatric emergency departments (controls n=110). MAIN OUTCOMEMEASURES:
Descriptive analysis of WHO severity criteria and major interventions (mechanical ventilation, blood transfusion, fluid challenge, treatment of cerebral oedema, renal replacement therapy). Thresholds were set by receiver operating characteristics curve analysis.RESULTS:
Altered consciousness (71% vs 5%), shock (24% vs 1%), renal failure (20% vs 1%), anaemia <50â g/L (7% vs 2%), acidosis (38% vs 0%), bilirubin level >50â µmol/L (25% vs 8%) and parasitaemia >10% (30% vs 8%) were more frequent in cases (p<0.01). All these criteria were associated with major interventions (p<0.001). Respiratory distress (six cases), and hypoglycaemia (two cases) were infrequent. Thrombocytopenia <50â 000/mm3 (46% vs 7%) and anaemia (haemoglobin concentration <70â g/L (41% vs 13%)) were more frequent in cases (p<0.0001).CONCLUSIONS:
The WHO severity criteria for paediatric Pf malaria are relevant for countries without endemic malaria. The infrequent but severe complications also provide a timely reminder of the morbidity and mortality associated with this condition worldwide. In non-endemic countries haemoglobin <70â g/L and platelet count <50â 000/mm3 could be used as additional criteria to identify children needing high level of care.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecção Hospitalar
/
Malária Falciparum
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Humans
/
Infant
País/Região como assunto:
Europa
Idioma:
En
Revista:
Arch Dis Child
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
França