Severe malaria in children:: a five-year survey in French intensive care units.

Background. - Severe malaria is a frequent complication of Plasmodium falciparum infections. More than one million children die of malaria each year. Material and methods. - A French survey was carried out on 15 cases admitted to pediatric intensive care units between 1990 and 1995. The aim of this work was to evaluate the occurrence, mortality, morbidity and treatment of severe malaria in French intensive care units. Results. - All cases were imported from Africa except one case of airport malaria. Diagnosis of many of these cases was delayed. All cases were treated with quinine, and five children received a loading dose. One child died and one has neurological sequelae. Discussion. - Despite improvement in management, the prognosis of severe malaria remains poor. With reference to the literature, we propose management of severe malaria, emphasizing the necessity of a rapid effect with a loading dose of quinine. (C) 2000 Editions scientifiques et medicales Elsevier SAS.