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Severe malaria in Europe : an 8-year multi-centre observational study

Kurth, Florian and Develoux, Michel and Mechain, Matthieu and Malvy, Denis and Clerinx, Jan and Antinori, Spinello and Gjørup, Ida E. and Gascon, Joaquím and Mørch, Kristine and Nicastri, Emanuele and Ramharter, Michael and Bartoloni, Alessandro and Visser, Leo and Rolling, Thierry and Zanger, Philipp and Calleri, Guido and Salas-Coronas, Joaquín and Nielsen, Henrik and Just-Nübling, Gudrun and Neumayr, Andreas and Hachfeld, Anna and Schmid, Matthias L. and Antonini, Pietro and Lingscheid, Tilman and Kern, Peter and Kapaun, Annette and da Cunha, José Saraiva and Pongratz, Peter and Soriano-Arandes, Antoni and Schunk, Mirjam and Suttorp, Norbert and Hatz, Christoph and Zoller, Thomas. (2017) Severe malaria in Europe : an 8-year multi-centre observational study. Malaria journal, 16. p. 57.

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Official URL: http://edoc.unibas.ch/54660/

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Abstract

Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria.; The European Network for Tropical Medicine and Travel Health (TropNet) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria.; From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections were acquired in West Africa (109/185, 59%). The proportion of patients treated with intravenous artesunate increased from 27% in 2006 to 60% in 2013. Altogether, 56 different combinations of intravenous and oral drugs were used across 28 study centres. The risk of acute renal failure (36 vs 17% p = 0.04) or cerebral malaria (54 vs 20%, p = 0.001) was significantly higher in patients ≥60 years than in younger patients. Respiratory distress with the need for mechanical ventilation was significantly associated with the risk of death in the study population (13 vs 0%, p = 0.001). Post-artemisinin delayed haemolysis was reported in 19/70 (27%) patients treated with intravenous artesunate.; The majority of patients with severe malaria in this study were tourists or migrants acquiring the infection in West Africa. Intravenous artesunate is increasingly used for treatment of severe malaria in many European treatment centres and can be given safely to European patients with severe malaria. Patients treated with intravenous artesunate should be followed up to detect and manage late haemolytic events.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Travel Clinic (Neumayr)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Medicine > Travel Clinic (Neumayr)
UniBasel Contributors:Neumayr, Andreas and Hatz, Christoph
Item Type:Article, refereed
Publisher:BioMed Central
ISSN:1475-2875
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:25 Apr 2017 09:52
Deposited On:25 Apr 2017 09:52

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