Dg. Lalloo et al., SEVERE AND COMPLICATED FALCIPARUM-MALARIA IN MELANESIAN ADULTS IN PAPUA-NEW-GUINEA, The American journal of tropical medicine and hygiene, 55(2), 1996, pp. 119-124
Citations number
25
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
Severe falciparum malaria usually occurs in children, but also occurs
in nonimmune migrants or partially immune adults in areas of unstable
transmission. We have studied prospectively 70 adult patients with str
ictly defined severe malaria from the south coast of Papua New Guinea
where malaria transmission is not intense. Only 19 (27.1%) were migran
ts from areas where malaria transmission does not occur; many other pa
tients were periurban dwellers who had become infected after visits to
their home villages. The most common clinical features were jaundice
or hepatic dysfunction, impaired consciousness, renal failure, cerebra
l malaria, and anemia. Hypoglycemia was common following treatment wit
h quinine. The overall case fatality rate was 18.6%; renal failure and
cerebral malaria in particular were associated with a poor outcome. R
eduction in mortality might be achieved by aggressive therapy of renal
failure with earlier institution of dialysis; the use of preventive m
easures for immigrants or urban dwellers returning to high transmissio
n areas might reduce the incidence of this dangerous disease.