Exchange Transfusion and Predictors of Outcome in Severe Falciparum Malaria

Title: Exchange Transfusion and Predictors of Outcome in Severe Falciparum Malaria

Authors: AE Mathew, AJ Mathew, D Tariang, S Longtrai, GM Varghese

DOI: https://dx.doi.org/10.18535/jmscr/v4i10.50

Abstract

Introduction

With an estimated 300-350 million cases and 1-3 million deaths, annually, malaria continues to be a major health concern especially in Sub-Saharan Africa and South-East Asia.¹ In India malaria has staged a comeback after the early 1960s when an all-time low of malaria cases (49,151 in 1963) seemed to suggest the possibility of an impending eradication. During the last few years India has recorded about 2 million confirmed malarial cases and 1,000 deaths annually. These figures reveal just the tip of the iceberg as the WHO estimates about 15 million cases and 20,000 deaths annually.² Severe malaria occurs when the effective treatment is delayed, either because of poor access to health care and delay in diagnosis or because the drugs given are ineffective in rapidly clearing the parasite.³ Non-immune individuals are particularly susceptible to severe falciparum malaria. Multiple organ dysfunction occurs once the disease takes a severe course, causing mortality as high as 50%. There is little pharmaceutical interest in development of new drugs due to low monetary returns on investment⁴ and there have been no major advances since the extraction of artemesinin and its derivatives in the early 1970s. With the recent emergence of geographical areas of artemesinin resistance,⁵ research and development of new drugs as well as revisiting available treatment modalities is a pressing need.

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Corresponding Author

AE Mathew