title: Age as a risk factor for severe manifestations and fatal outcome of falciparum malaria in European patients: observations from TropNetEurop and SIMPID Surveillance Data.
abstract: Previous studies have indicated that age is a risk factor for severe falciparum malaria in nonimmune patients. The objectives of this study were to reevaluate previous findings with a larger sample and to find out how strongly clinical outcomes for elderly patients differ from those for younger patients. Results of adjusted analyses indicated that the risks of death due to falciparum malaria, of experiencing cerebral or severe disease in general, and of hospitalization increased significantly with each decade of life. The case-fatality rate was almost 6 times greater among elderly patients than among younger patients, and cerebral complications occurred 3 times more often among elderly patients. Antimalarial chemoprophylaxis was significantly associated with a lower case-fatality rate and a lower frequency of cerebral complications. Women were more susceptible to cerebral complications than were men. Our study provides evidence that falciparum malaria is more serious in older patients and demonstrates that clinical surveillance networks are capable of providing quality data for investigation of rare events or diseases.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, University of Munich, Munich, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Mühlberger
authors.forename: T
authors.initials: T
authors.lastname: Jelinek
authors.forename: R H
authors.initials: RH
authors.lastname: Behrens
authors.forename: I
authors.initials: I
authors.lastname: Gjørup
authors.forename: J P
authors.initials: JP
authors.lastname: Coulaud
authors.forename: J
authors.initials: J
authors.lastname: Clerinx
authors.forename: S
authors.initials: S
authors.lastname: Puente
authors.forename: G
authors.initials: G
authors.lastname: Burchard
authors.forename: J
authors.initials: J
authors.lastname: Gascon
authors.forename: M P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: T
authors.initials: T
authors.lastname: Weitzel
authors.forename: T
authors.initials: T
authors.lastname: Zoller
authors.forename: H
authors.initials: H
authors.lastname: Kollaritsch
authors.forename: J
authors.initials: J
authors.lastname: Beran
authors.forename: J
authors.initials: J
authors.lastname: Iversen
authors.forename: C
authors.initials: C
authors.lastname: Hatz
authors.forename: M L
authors.initials: ML
authors.lastname: Schmid
authors.forename: A
authors.initials: A
authors.lastname: Björkman
authors.forename: K
authors.initials: K
authors.lastname: Fleischer
authors.forename: Z
authors.initials: Z
authors.lastname: Bisoffi
authors.forename: W
authors.initials: W
authors.lastname: Guggemos
authors.forename: J
authors.initials: J
authors.lastname: Knobloch
authors.forename: A
authors.initials: A
authors.lastname: Matteelli
authors.forename: M H
authors.initials: MH
authors.lastname: Schulze
authors.forename: H
authors.initials: H
authors.lastname: Laferl
authors.forename: A
authors.initials: A
authors.lastname: Kapaun
authors.forename: P
authors.initials: P
authors.lastname: McWhinney
authors.forename: R
authors.initials: R
authors.lastname: Lopez-Velez
authors.forename: G
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: P
authors.initials: P
authors.lastname: Kern
authors.forename: B W
authors.initials: BW
authors.lastname: Zieger
authors.forename: A
authors.initials: A
authors.lastname: Kotlowski
authors.forename: G
authors.initials: G
authors.lastname: Fry
authors.forename: J
authors.initials: J
authors.lastname: Cuadros
authors.forename: B
authors.initials: B
authors.lastname: Myrvang
mesh_terms: D000367:Age Factors; D000368:Aged; D000818:Animals; D005060:Europe / Q000453:epidemiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D012307:Risk Factors