Malaria: severe, life-threatening.
BACKGROUND
Severe malaria mainly affects children under 5 years old, non-immune travellers, migrants to malarial areas, and people living in areas with unstable or seasonal malaria. Cerebral malaria, causing encephalopathy and coma, is fatal in around 20% of children and adults, and neurological sequelae may occur in some survivors. Severe malarial anaemia may have a mortality rate of over 13%.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antimalarial treatments; and adjunctive treatment for complicated falciparum malaria in non-pregnant people? We searched: Medline, Embase, The Cochrane Library and other important databases up to December 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 31 systematic reviews, RCTs, or observational studies that met our inclusion criteria.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: dexamethasone, exchange blood transfusion, initial blood transfusion, intramuscular artemether, intravenous artesunate.
Omari
Aika Amy Anita
AA
Glan Clwyd Hospital, Rhyl, Denbighshire, UK.
Garner
Paul
P
D000284:Administration, Oral; D000962:Antimalarials / Q000008:administration & dosage; D006801:Humans; D016779:Malaria, Cerebral / Q000188:drug therapy; D016778:Malaria, Falciparum / Q000188:drug therapy; D011803:Quinine / Q000008:administration & dosage; D012717:Sesquiterpenes / Q000008:administration & dosage
D000962:Antimalarials; D012717:Sesquiterpenes; D011803:Quinine