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Oceane Minka S, Cottrell G, Cot M, Hillary Minka F, Thellier M, Choquet C, Houze S. New guidelines reduce the risk of hospitalization for adult patients with uncomplicated Plasmodium falciparum malaria: An observational, multicenter, retrospective French study. Infect Dis Now 2024; 54:104963. [PMID: 39173714 DOI: 10.1016/j.idnow.2024.104963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 08/05/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES We aimed to evaluate the impact of malaria declaration year (before or after 2017) on the frequency of hospitalization in metropolitan France of patients with uncomplicated non-vomiting P.falciparum malaria. PATIENTS AND METHODS An observational, multicenter, retrospective study was carried out, using the database from the French National Reference Centre for Malaria. Descriptive analysis and multivariate analysis by logistic regression were performed using the multiple imputation by chained equation method to handle missing data. RESULTS More than 2000 (2184) uncomplicated non-vomiting P.falciparum malaria cases were recorded. Our multivariate analysis showed an association between the year 2018 and reduced risk of hospitalization (OR: 0.89; 95% CI: 0.81-0.97). CONCLUSION Compared to 2016, during 2018 we observed a trend toward ambulatory care for patients presenting with uncomplicated non-vomiting P.falciparum malaria.
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Affiliation(s)
- Sally Oceane Minka
- Centre Hospitalier Universitaire de Bichat, Service des Urgences, 75018 Paris, France; Université Paris Cité, 75006 Paris, France.
| | | | - Michel Cot
- Faculté de pharmacie, IRD, UMR-MERIT, 75006 Paris, France
| | - Fadi Hillary Minka
- Centre Hospitalier Universitaire de Lariboisière, Service des Urgences, 75010 Paris, France; Université Paris Cité, 75006 Paris, France
| | - Marc Thellier
- Centre Hospitalier Universitaire de la Pitié Salpétrière, CNR du Paludisme, 75013 Paris, France; Université Sorbonne Paris Nord, 75013 Paris, France
| | - Christophe Choquet
- Centre Hospitalier Universitaire de Bichat, Service des Urgences, 75018 Paris, France
| | - Sandrine Houze
- Faculté de pharmacie, IRD, UMR-MERIT, 75006 Paris, France; Centre Hospitalier Universitaire de Bichat, CNR du Paludisme, 75018 Paris, France
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Bosilkovski M, Khezzani B, Poposki K, Semenakova-Cvetkovska V, Vidinic I, Lloga AO, Jakimovski D, Dimzova M. Epidemiological and clinical characteristics of imported falciparum malaria in the Republic of North Macedonia : A 13-year experience. Wien Klin Wochenschr 2023; 135:609-616. [PMID: 37010597 DOI: 10.1007/s00508-023-02192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Plasmodium falciparum is the leading cause of imported malaria and the most common cause of death in returning travellers. AIM To identify the main epidemiological and clinical characteristics of patients with imported falciparum malaria in the Republic of North Macedonia. MATERIAL AND METHODS Retrospectively analyzed were the epidemiological and clinical features of 34 patients with imported falciparum malaria who were diagnosed and treated at the university clinic for infectious diseases and febrile conditions in Skopje from 2010 to 2022. Malaria diagnosis was based on the microscopic detection of parasites in thick and thin blood smears. RESULTS All patients were male, with a median age of 36 years and a range of 22-60 years. Of the patients 33 (97.1%) acquired the disease in Sub-Saharan Africa. All patients except one stayed in endemic regions for work/business purposes. Chemoprophylaxis was completely applied in 4 (11.8%) patients. The median time of onset between the symptoms and diagnosis was 4 days, with a range of 1-12 days. Prevailing clinical manifestations were fever, chills, and splenomegaly in 100%, 94%, and 68% of patients, respectively. Severe malaria was noticed in 8 (23.5%) patients. In 5 (14.7%) patients the initial parasitemia was higher than 5%. On admission, thrombocytopenia, hyperbilirubinemia, and elevated alanine aminotransferase were registered in 94%, 58%, and 62% of patients, respectively. Out of the 33 patients with adequate follow-up, the outcome was favorable in 31 (93.9%). CONCLUSION In every febrile traveller returned from Africa, imported falciparum malaria should be an essential part of differential diagnostic considerations.
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Affiliation(s)
- Mile Bosilkovski
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Bachir Khezzani
- Department of Biology, Faculty of Natural and Life Sciences, University of El Oued, PO Box 789, 39000, El Oued, Algeria.
- Laboratory of Biology, Environment and Health (LBEH), Faculty of Natural and Life Sciences, University of El Oued, PO Box 789, 39000, El Oued, Algeria.
| | - Kostadin Poposki
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Vesna Semenakova-Cvetkovska
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Ivan Vidinic
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Arlinda Osmani Lloga
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Dejan Jakimovski
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
| | - Marija Dimzova
- University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss.Cyril and Methodius in Skopje, Skopje, Republic of North Macedonia
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Flateau C, Pitsch A, Cornaglia C, Picque M, de Pontfarcy A, Leroy P, Jault T, Thach C, Camus M, Dolveck F, Diamantis S. Management of imported malaria in the emergency department: Adequacy compared to guidelines, and impact of the SARS-CoV-2 pandemic. Infect Dis Now 2023; 53:104672. [PMID: 36773811 PMCID: PMC9912039 DOI: 10.1016/j.idnow.2023.104672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/13/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES Adequacy of imported malaria management with respect to guidelines in emergency departments (ED) is low. We aimed to identify factors associated with this non-compliance, and a potential impact of the SARS-CoV-2 pandemic. PATIENTS AND METHODS Patients presenting with imported malaria at the ED of the hospital of Melun (France), from January 1, 2017 to February 14, 2022 were retrospectively included. RESULTS Among 205 adults and 25 children, biological criteria of severity were fully assessed in 10% of cases; lactates (40%) and blood pH (21%) levels were the main missing variables. Of 74 patients (32%) with severe malaria, 13 were misclassified as uncomplicated malaria. The choice and dosage of treatment were adequate in 85% and 92% of cases, respectively. Treatment conformity was lower in severe malaria cases than in non-severe malaria cases (OR 0.15 [95% CI 0.07-0.31]), with oral treatment in 17 patients with severe malaria; conformity was higher in the intensive care unit (OR 4.10 [95% CI 1.21-13.95]). Patients with severe malaria were more likely to start treatment within 6hours than patients with uncomplicated malaria (OR 1.97 [95% CI 1.08-3.43]), as were patients infected by P.falciparum compared to other species (OR 4.63 [95% CI 1.03-20.90]). Consulting during the SARS-CoV-2 pandemic was the only organizational factor associated with a lower probability of adequate management (OR 0.42 [95% CI 0.23-0.75]). CONCLUSION Initial evaluation of malaria severity and time to treatment administration could be improved. These have been adversely impacted by the SARS-CoV-2 pandemic.
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Affiliation(s)
- C. Flateau
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France,Corresponding author at: Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France. Fax: + 33 1 81 74 18 12
| | - A. Pitsch
- Laboratoire de biologie médicale, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - C. Cornaglia
- Service d’accueil des urgences, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - M. Picque
- Laboratoire de biologie médicale, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - A. de Pontfarcy
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - P. Leroy
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - T. Jault
- Service de gynécologie-obstétrique, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - C. Thach
- Service de pédiatrie, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - M. Camus
- Pharmacie hospitalière, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - F. Dolveck
- Service d’accueil des urgences, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - S. Diamantis
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
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Cohen A. Role of the European Pharmacist in the Implementation of the Latest WHO Guidelines for Malaria. Pathogens 2023; 12:pathogens12050729. [PMID: 37242399 DOI: 10.3390/pathogens12050729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Following the publication a few months ago of the new WHO guidelines for malaria, the European pharmacist, even out of endemic areas, as a health care professional and advisor, has a major role to play in their effective implementation and in the interest of public health. The pharmacist is central in the health care system to ensure the correct application of these recommendations and to perform a decisive role in the prevention of malaria infections, both in the adapted pharmaceutical advice on personal protection against biting vector insects on the one hand, and in the pharmaceutical analysis and recommendations concerning antimalarial chemoprophylaxis prescriptions on the other hand. Physicians and pharmacist biologists, as well as hospital pharmacists, are also important for the analysis and treatment of effective malaria cases, particularly in the management of the diagnostic and therapeutic emergency that a P. falciparum infection represents.
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Affiliation(s)
- Anita Cohen
- Faculty of Pharmacy, University of Aix-Marseille, IRD, AP-HM, SSA, VITROME, F-13005 Marseille, France
- Assistance Publique-Hôpitaux de Marseille, Pharmaceutical Expertise and Clinical Research Unit, Pharmacy Department, APHM, F-13000 Marseille, France
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Mahittikorn A, Mala W, Wilairatana P, Siri S, Masangkay FR, Kotepui KU, Kotepui M. Prevalence, anti-malarial chemoprophylaxis and causes of deaths for severe imported malaria: A systematic review and meta-analysis. Travel Med Infect Dis 2022; 49:102408. [PMID: 35985533 DOI: 10.1016/j.tmaid.2022.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND There are limited data regarding prevalence, anti-malarial chemoprophylaxis, and causes of death for severe imported malaria. Thus, we conducted a systematic review and meta-analysis to characterise these variables. METHODS We searched studies reporting deaths attributable to severe imported malaria. The following pooled prevalence rates were determined: 1) the pooled prevalence of severe malaria among patients with imported malaria, 2) the pooled prevalence of deaths among patients with severe imported malaria, 3) the pooled prevalence of anti-malarial chemoprophylaxis among patients with severe imported malaria, and 4) the causes of death among patients with severe imported malaria. RESULTS The search identified 52 studies that were mainly conducted in Europe (25, 48.1%), North America (16, 30.8%) and Asia (7, 13.5%). The pooled prevalence of severe imported malaria was 12.5% (95% confidence interval [CI] = 10.3%-14.6%, I2 = 99.32%, 12393 severe cases/118325 imported cases). The pooled prevalence of deaths attributable to severe imported malaria was 5.1% (95% CI = 4.0%-6.2%, I2 = 91.72%, 721 deaths/16310 severe cases). The pooled prevalence of adequate anti-malarial chemoprophylaxis among patients with severe imported malaria was 9.7% (95% CI = 6.5%-13.0%, I2 = 89.9%, 203/2049 cases). The most common cause of death was multi-organ failure (12.3%). CONCLUSION The results highlighted the need for education and preventative measures for travellers, immigrants, or workers who plan to visit malaria-endemic areas to minimize the risk of severe disease or death.
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Affiliation(s)
- Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Sukhontha Siri
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
| | | | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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