[Imported severe malaria in adults: a retrospective study of ten cases admitted to intensive care units in Casablanca].
BACKGROUND
We report a retrospective study in the medical intensive care unit of the Casablanca Ibn-Rochd University hospital.


METHODS
All patients over 14 years of age with falciparum malaria, who were admitted to ICUs between 1996 and 2001, were included. The main epidemiological features, criteria of admission, treatment, and outcome were investigated.


RESULTS
Ten patients were included for severe imported malaria. The mean age was 32+/-4 years. All patients had acquired falciparum malaria in sub-Saharan Africa. Chemoprophylaxis was inadequate in all patients. The mean time from symptom onset to treatment initiation was 9+/-2 days. Criteria of admission were impaired consciousness (7), acute renal failure (4), and respiratory distress (3). The most worrying factors were the severity of consciousness disorders, the acute respiratory distress syndrome, the metabolic acidosis, and the refractory shock. All patients presented with nosocomial respiratory infection related to Gram-negative bacilli, in the evolution. All patients received quinine therapy with loading dose and symptomatic treatment. Five patients died.


CONCLUSIONS
The lethality of severe imported malaria is still high despite optimal management in ICUs. Improving chemoprophylaxis and an earlier diagnosis may reduce significantly the mortality rate.
Charra
B
B
Service de Réanimation Médicale, CHU Ibn-Rochd Casablanca, Maroc.
Sodqi
M
M
Sandali
O
O
Nejmi
H
H
Hachimi
A
A
Ezzouine
H
H
Benslama
A
A
Himmich
H
H
Motaouakkil
S
S
D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008288:Malaria / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D009018:Morocco; D012189:Retrospective Studies
D000962:Antimalarials