Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study

Bruneel, Fabrice; Tubach, Florence; Mira, Jean‐Paul; Houzé, Sandrine; Gibot, Sébastien; Huisse, Marie-Geneviève; Mégarbane, Bruno; Choquet, Christophe; Corne, Philippe; Peytel, E.; Villers, D.; Camus, Christophe; Bouchaud, Olivier; Caumes, Éric; Girard, Pierre‐Marie; Simon, Fabrice; Kalloumeh, Antoine; Roy, Carine; Durand, Rémy; Bras, J. Le; Matheron, Sophie; Wolff, Michel

doi:10.1007/s00134-016-4356-x

Cited by 42 publications

(42 citation statements)

References 36 publications

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“…This study presents clinical and treatment data from 28 centres of the TropNet from 12 countries, one of the largest databases collected on this patient population to date. Previous studies on severe malaria in Europe are only available either at centre [ 18 – 20 ] or country [ 3 , 21 – 23 ] level.…”

Section: Discussionmentioning

confidence: 99%

Severe malaria in Europe: an 8-year multi-centre observational study

Kurth

Develoux

Méchain³

et al. 2017

Malar J

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BackgroundMalaria 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.MethodsThe 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.ResultsFrom 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.ConclusionThe 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.

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Section: Discussionmentioning

confidence: 99%

Severe malaria in Europe: an 8-year multi-centre observational study

Kurth

Develoux

Méchain³

et al. 2017

Malar J

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“…Among 189 patients admitted in this ICU, the in-hospital mortality was 3.7%, lower than that described in previous studies among patients admitted for severe imported malaria [10][11][12]. In the multicentric SIMA study [10], 35 patients (including two deaths) of our ICU were included with a lower mortality rate than in other centers (5.7% vs 10.9%).…”

Section: Discussionmentioning

confidence: 73%

“…However, no difference were observed in the time interval between symptoms onset to ICU admission across both periods. SIMA and PALUREA, the two largest studies of imported malaria in France [10,11], were conducted before the availability of artesunate. Their mortality rates were higher than in our study, with death occurring during the first week of hospitalization in three out of four patients.…”

Section: Discussionmentioning

confidence: 99%

Changes in the clinical presentation and outcomes of patients treated for severe malaria in a referral French university intensive care unit from 2004 to 2017

Lebut

Mourvillier

Argy

et al. 2020

Ann. Intensive Care

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Background In France, the incidence of severe imported malaria cases increased since early 2000. Artesunate was available (temporarily use authorization) since mid-2011 in France and commonly used for severe malaria since early 2013. Thus, the study objectives were to describe the patients with severe imported malaria admitted in intensive care unit (ICU) and assess the changes in clinical presentation and outcomes before and after this date. Methods Retrospective observational single-center study in the infectious diseases ICU of a referral university hospital, conducted on patients admitted for severe imported malaria from 2004 to 2017. Demographic variables, severity scores, WHO’s severity criteria on admission, treatment, and ICU and hospital lengths of stay were collected. Patients’ characteristics and outcomes were compared between both periods. A poor outcome was defined as the composite endpoint of death, or requirement for vasopressors, invasive mechanical ventilation and/or renal replacement therapy. Results 189 patients were included, 98 in 2004–2012 and 91 in 2013–2017, most often from West and Central African countries (96%). The number of WHO criteria for severe malaria was comparable in both groups, but SAPS II, SOFA and ICU length of stay were significantly higher in 2004–2012, while patients of African origin living in France were less frequent (p < 0.01). The outcome was poor for 41/98 cases in 2004–2012 and 12/91 cases in 2013–2017 (p < 0.01). The risk factors of poor outcome on the multivariate logistic regression were a neurological failure (adjusted odds ratio (adjOR = 3.23; 95% CI (1.03–10.08), p = 0.004), cardio-circulatory failure (adjOR = 9.92; 95% CI (2.34–42), p = <0.01) and creatinine blood levels > 265 µmol/L (adjOR = 10.76; 95% CI (3.17–36.53), p < 0.01). In the multivariate analysis, IV artesunate was not associated with a better outcome. Patients of African origin did not seem to have a better outcome than Caucasian patients or those from other origins (adjOR = 0.59; 95% CI (0.21–1.65), p = 0.31). Conclusion Patients with imported malaria admitted in ICU in 2013–2017 were less severely ill than those in 2004–2012. These trends could be partially explained by the increasing proportion of African patients visiting friends or relatives or living in endemic areas.

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“…Con respecto al diagnóstico, la gota gruesa es el método más difundido para la malaria y el recomendado como primera opción en el proceso de detección, con una sensibilidad de 61.6% y especificidad 95.1% cuando se compara con la Proteína C Reactiva (PCR) como referencia estándar (26).…”

Section: Mundial De La Salud (Oms) Para El Año 2010 Para Este Tipo Deunclassified

Malaria grave en unidad de cuidados intensivos: Reporte de un caso de una especie no endémica en Norte de Santander, Colombia

Ortiz¹,

Urbina-Contreras²,

Lamos-Duarte

et al. 2018

MedUNAB

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Introducción: La malaria es una enfermedad infecciosa vectorial de predominio en regiones tropicales y subtropicales. Existen 5 serotipos de Plasmodium, en Colombia se encuentran dos serotipos para malaria endémica, P. vivax y P. falciparum. Norte de Santander es una zona endémica para P. vivax. Objetivo: Presentación de un caso de malaria grave importada por P. falciparum, con una breve descripción de los aspectos fisiopatológicos de la malaria grave y los advenimientos de las nuevas terapias antipalúdicas. Presentación del caso: Paciente masculino de 45 años procedente de una región endémica para P. falciparum, que ingresó por cuadro febril inespecífico, trombocitopenia severa, alteración de la función renal y hepática con deterioro de su estado general. Es trasladado a la unidad de cuidados intensivos como urgencia dialítica, se diagnóstica malaria grave por P. falciparum, es tratado con antimaláricos y se reporta posible coinfección para el virus del dengue por inmunoglobulina M positiva (IgM), recibe terapia de reemplazo renal. Se contextualiza bajo un círculo vicioso en la disfunción de órganos, estructurado entre la insuficiencia renal y la insuficiencia respiratoria aguda con incremento de la permeabilidad vascular e hipoxemia refractaria, pese al esfuerzo terapéutico fallece por falla * Médico, especialista en Medicina Interna, especialista en Medicina Crítica y Cuidado Intensivo, especialista en Epidemiología, doctorado en Medicina Traslacional, coordinador

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Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study

Abstract: During imported malaria, the most useful biomarkers associated with severity seem to be plasma albumin and sTREM-1; and among parasite-related parameters, PfHRP2 was more strongly associated with severity than parasitemia was.

Cited by 42 publications

References 36 publications

Severe malaria in Europe: an 8-year multi-centre observational study

Severe malaria in Europe: an 8-year multi-centre observational study

Changes in the clinical presentation and outcomes of patients treated for severe malaria in a referral French university intensive care unit from 2004 to 2017

Malaria grave en unidad de cuidados intensivos: Reporte de un caso de una especie no endémica en Norte de Santander, Colombia

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