Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

Version 1 : Received: 23 November 2020 / Approved: 24 November 2020 / Online: 24 November 2020 (09:51:45 CET)

A peer-reviewed article of this Preprint also exists.

Boushab, B.M.; Ould Ahmedou Salem, M.S.; Ould Mohamed Salem Boukhary, A.; Parola, P.; Basco, L. Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania. Trop. Med. Infect. Dis. 2021, 6, 1. Boushab, B.M.; Ould Ahmedou Salem, M.S.; Ould Mohamed Salem Boukhary, A.; Parola, P.; Basco, L. Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania. Trop. Med. Infect. Dis. 2021, 6, 1.

Journal reference: Trop. Med. Infect. Dis. 2020, 6, 1
DOI: 10.3390/tropicalmed6010001

Abstract

Severe malaria in adults is not well studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (P < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, i.e. parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

Keywords

Artesunate; Drug resistance; Malaria; Quinine; Rapid diagnostic test; Plasmodium falciparum; Sahel

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