| Severe malaria in African adults living in a seasonal endemic area. | |
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MedLine Citation:
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PMID: 7798449 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This study investigates severe malaria in African adults living in a seasonal endemic area. DESIGN: A prospective study of all adults admitted with severe malaria over 2 consecutive seasons: October 1990 till January 1991 and October 1991 till January 1992. SETTING: ICU (15 beds) of Hôpital Principal, Dakar, Sénégal. PATIENTS: 23 patients: 14 men and 9 women with a mean age of 30 +/- 3 years were included in the study; all fulfilled the 1990 WHO criteria for severe malaria. RESULTS: At admission, 12 patients were comatose (Glasgow Coma Scale < 10), 7 had generalized convulsions. Parasitaemia was 135 +/- 52 x 10(9)/l. Biological indications of severity were as follows: hypophosphataemia < 0.8 mmol/l in 14 cases, serum creatine phosphokinase > 500 IU/l in 15 cases; and PaO2 < 70 mmHg in 5 cases. Serum TNF alpha levels, measured in 16 cases, were increased at 298.4 +/- 63.5 pg/ml, serum levels of IL-6 and IL-2SR were also elevated: 609.5 +/- 304.2 pg/ml and 297.6 +/- 35.6 pg/ml respectively. Circulating IgM and IgG antibodies were found in 14 out of 16 patients. Serum levels of TNF alpha, IL-6 and IL-2SR correlated positively with each other. TNF alpha and IL-2SR were also positively correlated to parasitaemia. Intravenous therapy with quinine at loading dose was favorable in 19 patients. Four patients died during the study, 3 from multiple organ failure. CONCLUSIONS: This work demonstrated that severe malaria in a seasonal endemic area displays original clinical features with a high rate of either cerebral malaria or multiple organ failure. |
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Authors:
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J M Saïssy; M Vitris; B Diatta; J Kempf; F Adam; J L Sarthou |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Intensive care medicine Volume: 20 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 1994 Jul |
Date Detail:
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Created Date: 1995-01-26 Completed Date: 1995-01-26 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 437-41 Citation Subset: IM |
Affiliation:
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Service de Réanimation et de Soins Intensifs, Hôpital Principal, Dakar, Sénégal. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Case-Control Studies Female Hospital Mortality Humans Intensive Care Units Malaria, Cerebral / epidemiology, etiology Malaria, Falciparum / blood*, complications, epidemiology, physiopathology* Male Middle Aged Multiple Organ Failure / epidemiology, etiology Prospective Studies Seasons Senegal / epidemiology Severity of Illness Index Survival Rate |
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