Imported severe malaria and risk factors for intensive care: A single-centre retrospective analysis

PLoS One. 2019 Nov 14;14(11):e0225135. doi: 10.1371/journal.pone.0225135. eCollection 2019.

Abstract

Objectives: This study aims to identify the risk factors for intensive care (IC) in severe malaria patients admitted to the "Lazzaro Spallanzani" National Institute for Infectious Diseases, Rome, Italy.

Methods: All patients with confirmed severe malaria and hospitalized between 2007 and 2015 were included in the analysis and stratified into two groups: those requiring IC and those who did not. Five prognostic malaria scores were estimated; clinical severity at IC unit admission was assessed using the Sequential Organ Failure Assessment and the quick-Sequential Organ Failure Assessment scores. Univariate and multivariate analysis were performed to assess factors independently associated to IC.

Results: A total of 98 severe malaria patients were included; 10 of them required IC. There were no deaths or sequelae. Patients requiring IC had higher severity scores. At the multivariate analysis, only the number of World Health Organization criteria and the aspartate aminotransferase value were independently associated with the need of IC.

Conclusions: An early and accurate assessment of the severity score is essential for the management of severe malaria patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communicable Diseases, Imported / diagnosis
  • Communicable Diseases, Imported / epidemiology*
  • Communicable Diseases, Imported / parasitology
  • Comorbidity
  • Critical Care*
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Malaria / diagnosis
  • Malaria / epidemiology*
  • Malaria / parasitology
  • Malaria / transmission*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Rome / epidemiology
  • Severity of Illness Index

Grants and funding

This study was supported by Ricerca Corrente and Ricerca finalizzata WFR PE-2013-02357936 funded by the Italian Ministry of Health to EN.