Briand V, Bouchaud O, Tourret J, Behr C, Abgrall S, Ralaimazava P, Le Bras J, Fontanet A. Hospitalization criteria in imported falciparum malaria.
J Travel Med 2007;
14:306-11. [PMID:
17883461 DOI:
10.1111/j.1708-8305.2007.00143.x]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Controversy exists about the management of patients with imported Plasmodium falciparum malaria. We postulated that rapid parasite clearance supports ambulatory care, or, conversely, that factors associated with longer parasite clearance time (PCT) could be used as hospitalization criteria.
METHODS
Hospitalized patients with imported falciparum malaria recruited through one single travel clinic between 1993 and 2000. We used a linear regression to identify factors independently associated with PCT defined as the time in hours from antimalarial drug administration until the first negative malaria smear.
RESULTS
Among 400 patients hospitalized with falciparum malaria, mean (range) PCT was 58 (1-189) hours. In multivariate analysis, severe malaria, gastrointestinal signs, initial temperature greater than or equal to 40 degrees C, parasitemia greater than or equal to 1%, and platelet counts less than 50,000/microL were associated with longer PCT. Offering ambulatory care to patients aged 15 to 64 years with none of the factors associated with longer PCT in the study would have resulted in 147 (37%) patients receiving outpatient care.
CONCLUSION
Factors identified in this model may help physicians determine which P falciparum malaria patients can be treated on an ambulatory basis, and contribute to revisions of national guidelines for imported malaria management.
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