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Severe imported Plasmodium falciparum malaria in French paediatric intensive care units
  1. Delane Shingadia
  1. Correspondence to Dr Delane Shingadia, Department of Infectious Diseases, Great Ormond Street Hospital, Great Ormond Street, WC1N 3JH London, UK; delane.shingadia{at}gosh.nhs.uk

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Severe Plasmodium falciparum (Pf) malaria is a major cause of morbidity and mortality worldwide, particularly in malaria-endemic areas. The paper by Lanneaux et al1 aims to assess the relevance of WHO severity criteria for paediatric Pf malaria in an industrialised country. The authors retrospectively identified children with Pf malaria admitted to eight paediatric intensive care units (PICU) and paediatric emergency departments in France over a 6-year period and conducted a case–control study to analyse WHO severity criteria and major interventions (mechanical ventilation, blood transfusion, fluid challenge, treatment of cerebral oedema and renal replacement). The WHO severity criteria for paediatric Pf malaria were still found to be relevant for countries not endemic for Pf malaria. A similar spectrum of complications, although at lower frequencies than in malaria-endemic countries, was found. In particular, altered consciousness (70%) and circulatory collapse (23%) accounted for the bulk of severe disease requiring admission to PICU. Interestingly, there were no deaths reported in this study, similar to that of our study of PICU …

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