Deaths From Plasmodium knowlesi Malaria: Case Series and Systematic Review.
In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Jg. 69 (2019-10-30), Heft 10, S. 1703-1711
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Zugriff:
Background: Plasmodium knowlesi causes severe and fatal malaria, and incidence in Southeast Asia is increasing. Factors associated with death are not clearly defined.
Methods: All malaria deaths in Sabah, Malaysia, from 2015 to 2017 were identified from mandatory reporting to the Sabah Department of Health. Case notes were reviewed, and a systematic review of these and all previously reported fatal P. knowlesi cases was conducted. Case fatality rates (CFRs) during 2010-2017 were calculated using incidence data from the Sabah Department of Health.
Results: Six malaria deaths occurred in Sabah during 2015-2017, all from P. knowlesi. Median age was 40 (range, 23-58) years; 4 cases (67%) were male. Three (50%) had significant cardiovascular comorbidities and 1 was pregnant. Delays in administering appropriate therapy contributed to 3 (50%) deaths. An additional 26 fatal cases were included in the systematic review. Among all 32 cases, 18 (56%) were male; median age was 56 (range, 23-84) years. Cardiovascular-metabolic disease, microscopic misdiagnosis, and delay in commencing intravenous treatment were identified in 11 of 32 (34%), 26 of 29 (90%), and 11 of 31 (36%) cases, respectively. The overall CFR during 2010-2017 was 2.5/1000: 6.0/1000 for women and 1.7/1000 for men (P = .01). Independent risk factors for death included female sex (odds ratio, 2.6; P = .04), and age ≥45 years (odds ratio, 4.7; P < .01).
Conclusions: Earlier presentation, more rapid diagnosis, and administration of intravenous artesunate may avoid fatal outcomes, particularly in females, older adults, and patients with cardiovascular comorbidities.
(© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.)
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Deaths From Plasmodium knowlesi Malaria: Case Series and Systematic Review.
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Autor/in / Beteiligte Person: | Rajahram, GS ; Cooper, DJ ; William, T ; Grigg, MJ ; Anstey, NM ; Barber, BE |
Zeitschrift: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Jg. 69 (2019-10-30), Heft 10, S. 1703-1711 |
Veröffentlichung: | Jan. 2011- : Oxford : Oxford University Press ; <i>Original Publication</i>: Chicago, IL : The University of Chicago Press, c1992-, 2019 |
Medientyp: | academicJournal |
ISSN: | 1537-6591 (electronic) |
DOI: | 10.1093/cid/ciz011 |
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