RT Journal Article
T1 Severe malaria in Europe: an 8-year multi-centre observational study.
A1 Kurth, Florian
A1 Develoux, Michel
A1 Mechain, Matthieu
A1 Malvy, Denis
A1 Clerinx, Jan
A1 Antinori, Spinello
A1 Gjørup, Ida E
A1 Gascon, Joaquím
A1 Mørch, Kristine
A1 Nicastri, Emanuele
A1 Ramharter, Michael
A1 Bartoloni, Alessandro
A1 Visser, Leo
A1 Rolling, Thierry
A1 Zanger, Philipp
A1 Calleri, Guido
A1 Salas-Coronas, Joaquín
A1 Nielsen, Henrik
A1 Just-Nübling, Gudrun
A1 Neumayr, Andreas
A1 Hachfeld, Anna
A1 Schmid, Matthias L
A1 Antonini, Pietro
A1 Lingscheid, Tilman
A1 Kern, Peter
A1 Kapaun, Annette
A1 da Cunha, José Saraiva
A1 Pongratz, Peter
A1 Soriano-Arandes, Antoni
A1 Schunk, Mirjam
A1 Suttorp, Norbert
A1 Hatz, Christoph
A1 Zoller, Thomas
K1 Artesunate
K1 Clinical study
K1 Europe
K1 Falciparum
K1 Malaria
K1 Plasmodium
K1 Quinine
K1 Severe malaria
AB 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.
YR 2017
FD 2017-01-31
LK https://hdl.handle.net/10668/24837
UL https://hdl.handle.net/10668/24837
LA en
DS RISalud
RD Apr 7, 2025