Severe imported malaria involving hyperparasitemia (≥ 10%) in non-immune children : Assessment of French practices

Copyright © 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved..

BACKGROUND: Plasmodium falciparum hyperparasitemia (over or equal to 10%), isolated or associated with other severity criteria, should be managed in a pediatric intensive care unit according to the French pediatric guidelines. The main objective of our study was to describe the management and course of these special cases.

POPULATION AND METHODS: We conducted a retrospective study in eight French hospital facilities from January 2007 to December 2014. We reviewed the management of non-immune children aged 0-15 years, assessing the following: clinical and paraclinical data, type of care unit, treatment initiated, initial and long-term course. Data were analyzed for the whole population and for two groups according to the place of first-line management: group A (in pediatric intensive care unit), and group B (other places).

RESULTS: A total of 61 children were included, 14 (23%) of whom were initially admitted to the intensive care unit (group A), all with neurological or hemodynamic disorders. Only 23 children (38%) overall received intravenous antimalarial treatment and the other patients received exclusively oral treatment. No deaths were reported. Median parasitemia was comparable in the two groups. In group B (n = 47/61, 77%), isolated hyperparasitemia, jaundice, and renal failure were predominant. The children who underwent initial intravenous treatment (n = 5/47, 11%) all progressed favorably, as did 92% of the children who received oral treatment (n = 42/47, 89%).

CONCLUSION: A majority of children with Plasmodium falciparum hyperparasitemia were managed outside the pediatric intensive care unit via the oral route, against the French pediatric guidelines except when neurologic or hemodynamic disorders were present. Initial clinical evaluation and hospital supervision are essential for the best management of these patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:29

Enthalten in:

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie - 29(2022), 4 vom: 11. Mai, Seite 300-306

Sprache:

Englisch

Beteiligte Personen:

Vasse, C [VerfasserIn]
Faye, A [VerfasserIn]
Naudin, J [VerfasserIn]
Titomanlio, L [VerfasserIn]
Angoulvant, A [VerfasserIn]
Pham, L-L [VerfasserIn]
French National Specialist Center for Malaria [VerfasserIn]
Carbajal, R [VerfasserIn]
de Suremain, N [VerfasserIn]

Links:

Volltext

Themen:

Antimalarials
Children
France
Imported malaria
Journal Article
Parasitemia
Plasmodium falciparum

Anmerkungen:

Date Completed 12.05.2022

Date Revised 12.05.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.arcped.2022.01.014

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM338187618