title: Severe malaria in Europe: an 8-year multi-centre observational study
creator: Kurth, Florian
creator: Develoux, Michel
creator: Mechain, Matthieu
creator: Malvy, Denis
creator: Clerinx, Jan
creator: Antinori, Spinello
creator: Gjørup, Ida E.
creator: Gascon, Joaquím
creator: Mørch, Kristine
creator: Nicastri, Emanuele
creator: Ramharter, Michael
creator: Bartoloni, Alessandro
creator: Visser, Leo
creator: Rolling, Thierry
creator: Zanger, Philipp
creator: Calleri, Guido
creator: Salas-Coronas, Joaquín
creator: Nielsen, Henrik
creator: Just-Nübling, Gudrun
creator: Neumayr, Andreas
creator: Hachfeld, Anna
creator: Schmid, Matthias L.
creator: Antonini, Pietro
creator: Lingscheid, Tilman
creator: Kern, Peter
creator: Kapaun, Annette
creator: Saraiva da Cunha, José
creator: Pongratz, Peter
creator: Soriano‑Arandes, Antoni
creator: Schunk, Mirjam
creator: Suttorp, Norbert
creator: Hatz, Christoph
creator: Zoller, Thomas
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: 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.   Methods: 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.   Results: 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.   Conclusion: 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.
publisher: BioMed Central
date: 2017
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/22600/1/12936_2016_Article_1673.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-226006
identifier:   Kurth, Florian ; Develoux, Michel ; Mechain, Matthieu ; Malvy, Denis ; Clerinx, Jan ; Antinori, Spinello ; Gjørup, Ida E. ; Gascon, Joaquím ; Mørch, Kristine ; Nicastri, Emanuele ; Ramharter, Michael ; Bartoloni, Alessandro ; Visser, Leo ; Rolling, Thierry ; Zanger, Philipp ; Calleri, Guido ; Salas-Coronas, Joaquín ; Nielsen, Henrik ; Just-Nübling, Gudrun ; Neumayr, Andreas ; Hachfeld, Anna ; Schmid, Matthias L. ; Antonini, Pietro ; Lingscheid, Tilman ; Kern, Peter ; Kapaun, Annette ; Saraiva da Cunha, José ; Pongratz, Peter ; Soriano‑Arandes, Antoni ; Schunk, Mirjam ; Suttorp, Norbert ; Hatz, Christoph ; Zoller, Thomas  (2017) Severe malaria in Europe: an 8-year multi-centre observational study.  Malaria Journal, 16 (57).  pp. 1-11.  ISSN 1475-2875     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/22600/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng