title: [Severe imported malaria in adults: a retrospective study of thirteen cases admitted to the Intensive Care Unit in Marrakech].
abstract: Imported malaria is being seen with increasing frequency in non-endemic areas. Severe forms represent 10% of cases of Plasmodium falciparum malaria. In Morocco, more than 50 cases of malaria occur each year, 83% of which with Plasmodium falciparum malaria. All patients with severe malaria admitted to the Intensive Care Unit during the period between 1 November 2009 and 31 December 2015 were enrolled in our study. The main epidemiological data, the reasons for admission, the management and the outcomes of patients were studied. Thirteen patients were included in our study. The average age was 31 years. All patients had been living in sub-Saharan Africa and had no immunity to malaria. Chemoprophylaxis was adequate in 33% of cases. The mean time between symptom onset and treatment initiation was six days. Mean initial parasitemia was 12%. The main reasons for ICU admission included coma (15%), convulsion (07%), respiratory distress 07%), prostration (07%), renal failure (07%), shock associated with jaundice and acidosis (07%) and kidney failure associated with coma (07%). All patients were treated with intravenous quinine loading dose. Mortality rate was 23%. The causes of death were multi-system organ failure and acute respiratory distress syndrome. Mortality associated with severe malaria remains high. The adequacy of chemoprophylaxis associated with early diagnosis and treatment would significantly improve the prognosis of this parasitic infection.
authors.affiliation: Service de Parasitologie Mycologie, Hôpital Militaire Avicenne Marrakech, Maroc.
authors.forename: El Mostafa
authors.initials: EM
authors.lastname: El Mezouari
authors.affiliation: Service de Réanimation Médicale, Hôpital Militaire Avicenne Marrakech, Maroc.
authors.forename: Ayoub
authors.initials: A
authors.lastname: Belhadj
authors.affiliation: Service des Maladies Infectieuses, Hôpital Militaire Avicenne Marrakech, Maroc.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ziani
authors.affiliation: Service de Réanimation Médicale, Hôpital Militaire Avicenne Marrakech, Maroc.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Boughanem
authors.affiliation: Service de Parasitologie Mycologie, Hôpital Militaire Avicenne Marrakech, Maroc.
authors.forename: Redouane
authors.initials: R
authors.lastname: Moutaj
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D018890:Chemoprevention / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D009018:Morocco / Q000453:epidemiology; D018512:Parasitemia / Q000453:epidemiology; D011803:Quinine / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000962:Antimalarials; D011803:Quinine
keywords: Plasmodium falciparum; Severe malaria; resuscitation