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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 10/2016

11.05.2016 | Original

Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study

verfasst von: Fabrice Bruneel, Florence Tubach, Jean-Paul Mira, Sandrine Houze, Sebastien Gibot, Marie-Genevieve Huisse, Bruno Megarbane, Christophe Choquet, Philippe Corne, Eric Peytel, Daniel Villers, Christophe Camus, Olivier Bouchaud, Eric Caumes, Pierre-Marie Girard, Fabrice Simon, Antoine Kalloumeh, Carine Roy, Remy Durand, Jacques Le Bras, Sophie Matheron, Michel Wolff, The PALUREA Study Group

Erschienen in: Intensive Care Medicine | Ausgabe 10/2016

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Abstract

Purpose

Prospective data on potential factors associated with severity of imported Plasmodium falciparum malaria are lacking. We evaluated whether several host- and parasite-related biomarkers may improve early severity evaluation.

Methods

Prospective multicenter observational study comparing uncomplicated and severe imported falciparum malaria in adults conducted in France in 52 units, from 2007 to 2010. Association of several host- and parasite-related biomarkers with severity of malaria was tested using univariate and multivariate analyses.

Results

Of 295 patients, 140 had uncomplicated malaria and 155 severe malaria (including very severe and less severe cases according to predefined criteria). Curative intravenous quinine treatment was used in 154/155 patients with severe malaria and atovaquone/proguanil in 74 % of patients with uncomplicated malaria. Hospital mortality was 5.2 % (8 patients), all in the severe malaria group. Among host-related biomarkers, CRP, procalcitonin, and sTREM-1 were significantly higher and albumin was significantly lower in severe versus uncomplicated malaria; only the last three biomarkers also differed significantly between the very and less severe malaria groups. Among parasite-related biomarkers, only plasma PfHRP2 was significantly higher in severe versus uncomplicated malaria and in very severe versus less severe malaria; parasitemia did not differ between very and less severe malaria. By multivariate analysis, only lower plasma albumin and higher sTREM-1 were associated with greater severity, with intermediate accuracies.

Conclusions

During imported malaria, the most useful biomarkers associated with severity seem to be plasma albumin and sTREM-1; and among parasite-related parameters, PfHRP2 was more strongly associated with severity than parasitemia was.
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Metadaten
Titel
Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study
verfasst von
Fabrice Bruneel
Florence Tubach
Jean-Paul Mira
Sandrine Houze
Sebastien Gibot
Marie-Genevieve Huisse
Bruno Megarbane
Christophe Choquet
Philippe Corne
Eric Peytel
Daniel Villers
Christophe Camus
Olivier Bouchaud
Eric Caumes
Pierre-Marie Girard
Fabrice Simon
Antoine Kalloumeh
Carine Roy
Remy Durand
Jacques Le Bras
Sophie Matheron
Michel Wolff
The PALUREA Study Group
Publikationsdatum
11.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 10/2016
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-016-4356-x

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