TY  - JOUR
TI  - Severe malaria in Europe: an 8-year multi-centre observational study
Y1  - 2017///
AV  - public
SN  - 1475-2875
VL  - 16
ID  - heidok22600
JF  - Malaria Journal
SP  - 1
N2  - 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.
PB  - BioMed Central
EP  - 11
IS  - 57
CY  - London
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  - Saraiva da Cunha, José
A1  - Pongratz, Peter
A1  - Soriano?Arandes, Antoni
A1  - Schunk, Mirjam
A1  - Suttorp, Norbert
A1  - Hatz, Christoph
A1  - Zoller, Thomas
UR  - https://archiv.ub.uni-heidelberg.de/volltextserver/22600/
ER  -