PREDICTORS OF MORTALITY IN SEVERE MALARIA - A 2-YEAR EXPERIENCE IN A NONENDEMIC AREA

Management of severe malaria is an increasing problem worldwide, This paper reviews the pathophysiology and management documenting two years ' experience of admissions of severe malaria to an ICU in a non-endemi c area. Clinical and laboratory features of severe malaria were analys ed for predictors of mortality. Twenty-eight patients had clinical or laboratory features compatible with the WHO criteria for severe malari a and, despite treatment with intravenous quinine and supportive ICU c are, mortality was 28.5% (8/28). The three pregnant patients died with 100% foetal mortality and the four paediatric patients survived. Of t he non-survivors, 8/8 developed ARDS (defined by worst ALI score >2.5) , 7/8 developed shock requiring inotropic support and 7/8 developed ac ute renal failure requiring CVVHD. Admission haemoglobin platelet coun t, parasite count, and lowest Glasgow Coma Score in the first 24 hours were shown not to be predictors of mortality.