[Severe imported malaria. The experience of the military hospital of Marrakech].
Incidence of severe imported malaria increases with the multiplication of humanitarian and military missions in malarial endemic areas. The purpose of this study was to describe the demographic, clinical, therapeutic and outcome aspects of 9 cases which have been hospitalized in the intensive care unit and medecine service of the military hospital of Marrakech, between january 2001 and december 2004. Out of 68 patients admitted with symptomatic malaria during this period, 9 cases were considered as severe. All of them were male soldiers (mean age: 33,3 years), 7 of them have stayed in Democratic Republic of Congo, and 2 in Ivory Coast. Chemoprophylaxis consisted in chloroquine plus proguanil in 5 cases and mefloquine in 4 cases. The mean duration of stay in endemic area was 9,3 months. The clinical presentation was dominated by troubles of consciousness, which justified initial admission in the intensive care unit. The mean duration of hospitalization was 3,3 days in intensive care unit and 5,6 days in the medical department. Thick smear always revealed high parasitemia (5-15%) with Plasmodium falciparum, associated with Plasmodium ovale in two cases. Antimalarial treatment consisted in quinine salts administration. Evolution was favourable without recurrence in 7 cases, but 2 deaths were recorded. Severe imported malaria remains associated with bad outcome and requires early diagnosis and close monitoring of such cases.
Moudden
M-K
MK
Service de Médecine Interne, Hôpital Militaire Avicenne, Marrakech, Maroc. mouddenkarim@yahoo.fr
Boukhira
A
A
Zyani
M
M
Boughalem
M
M
Hda
A
A
D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D007560:Cote d'Ivoire; D015023:Democratic Republic of the Congo; D006772:Hospitals, Military; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D008887:Military Medicine; D009018:Morocco / Q000453:epidemiology; D002727:Proguanil / Q000627:therapeutic use; D011803:Quinine / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
D000962:Antimalarials; D002738:Chloroquine; D011803:Quinine; D002727:Proguanil; D015767:Mefloquine