Severe and Complicated Falciparum Malaria in Melanesian Adults in Papua New Guinea

David G. Lalloo Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Andrew J. Trevett Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Mark Paul Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Andrew Korinhona Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Ian F. Laurenson Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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James Mapao Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Nneka Nwokolo Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Brunie Danga-Christian Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Julie Black Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Adolf Saweri Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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Sirus Naraqi Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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David A. Warrell Department of Clinical Sciences, Faculty of Medicine, University of Papua New Guinea, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Boroko, Papua New Guinea

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DOI:
https://doi.org/10.4269/ajtmh.1996.55.119
Volume/Issue:
Volume 55: Issue 2
Page(s):
119–124
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Severe falciparum malaria usually occurs in children, but also occurs in nonimmune migrants or partially immune adults in areas of unstable transmission. We have studied prospectively 70 adult patients with strictly defined severe malaria from the south coast of Papua New Guinea where malaria transmission is not intense. Only 19 (27.1%) were migrants from areas where malaria transmission does not occur; many other patients were periurban dwellers who had become infected after visits to their home villages. The most common clinical features were jaundice or hepatic dysfunction, impaired consciousness, renal failure, cerebral malaria, and anemia. Hypoglycemia was common following treatment with quinine. The overall case fatality rate was 18.6%; renal failure and cerebral malaria in particular were associated with a poor outcome. Reduction in mortality might be achieved by aggressive therapy of renal failure with earlier institution of dialysis; the use of preventive measures for immigrants or urban dwellers returning to high transmission areas might reduce the incidence of this dangerous disease.
Copyright:
Copyright © 1996 by The American Society of Tropical Medicine and Hygiene 1996
Published Online:
Aug 1996
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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