Management of severe malaria

Management of severe malaria

Four species of Plasmodium have long been recog nized to cause malaria in humans – P. falci­ parum, P. vivax, P. malariae and P. ovale. A fifth species has recently been added to this list, P. knowlesi, identified as an important cause of human disease in Malaysia [1]. Traditionally it has been taught that only P. falciparum causes severe and life-threatening disease, but recent evidence indica...

MANAGEMENT OF SEVERE HYPERKALEMIA

Management of severe paediatric malaria in resource-limited settings

Over 90% of the world's severe and fatal Plasmodium falciparum malaria is estimated to affect young children in sub-Sahara Africa, where it remains a common cause of hospital admission and inpatient mortality. Few children will ever be managed on high dependency or intensive care units and, therefore, rely on simple supportive treatments and parenteral anti-malarials. There has been some progre...

Responding to the evidence for the management of severe malaria

Humanity owes a great debt to quinine. Cinchona alkaloids have been used to treat malaria for hundreds of years after the arrival of cinchona bark in Europe in the 17th century, where it was mixed with rose leaves, lemon juice and wine to treat the malarious patients of Essex (Butler et al. 2010). While quinine has been largely replaced by more effective and better-tolerated drugs in the treatm...

The fluid management of adults with severe malaria

Fluid resuscitation has long been considered a key intervention in the treatment of adults with severe falciparum malaria. Profound hypovolemia is common in these patients and has the potential to exacerbate the acidosis and acute kidney injury that are independent predictors of death. However, new microvascular imaging techniques have shown that disease severity correlates more strongly with o...