Résumé / Abstract

215 - Aspects cliniques et thérapeutiques du paludisme grave de l'adulte en milieu hospitalier à Antananarivo, Madagascar.

Epidemiological, clinical and therapeutic aspects of severe malaria in adult in hospital in Antananarivo, Madagascar.

R.A. Rakotoarivelo, H.F.R. Raveloson, R. Andrianasolo, S.H. Razafimahefa & M.J.D. Randria

paludisme - Plasmodium falciparum - complications - hôpital - Antananarivo - Madagascar - océan Indien

Few data are available about severe malaria in Madagascar. Our aims were to describe epidemiological, clinical and therapeutic aspects of severe malaria in patients in Antananarivo. We conducted a retrospective study from 1 March 2006 to 31 March 2008 at the infectious disease department. We recorded 61 cases of severe malaria among 1,803 in patients. Sex ratio was 2 and average age was 35.3 years old. Three pregnant women were recorded among women (15.8%). Self-medication was registered in 23%. Among 35 patients who received first medical care, no one had parasitological examination. The treatment was inadequate for all patients (n=19). Conscience impairment (65.6%), jaundice (24.6%), seizure (18%) and prostration (14.8%) were the major severe signs. Diagnosis was made 6.54 days after the onset of the disease. Mortality rate was 11.5%. Self-medication, inappropriate primary care and delayed diagnosis represented risk factors for severe malaria in our cohort.

malaria - Plasmodium falciparum - complications - hospital - Antananarivo - Madagascar - Indian Ocean

Références bibliographiques

  • 1. DIALLO AH, GUIGUEMDE TR & KI-ZERBO G - Aspects cliniques et parasitologiques du paludisme grave de l'adulte en milieu urbain de Bobo-Dioulasso (Burkina Faso). Bull Soc Pathol Exot, 2003, 96, 99-100. [http://www.pathexo.fr/SPE/abstract.php?id_article=3992]
  • 2. EHOLIE SP, EHUI E, ADOU-BRYN K, KOUAME KE & TANON A et al. - Paludisme grave de l'adulte autochtone à Abidjan (Côte d'Ivoire). Bull Soc Pathol Exot, 2004, 97, 340-344. [http://www.pathexo.fr/SPE/abstract.php?id_article=4157]
  • 3. KOFOED P-E, LOPES F, JOHANSSON P, DIAS F & SANDSTROM A et al. - Low-dose quinine for treatment of Plasmodium falciparum malaria in Guinea-Bissau. Trans R Soc Trop Med Hyg, 1999, 93, 547-549.
  • 4. KOFOED P-E, MAPABA E, LOPES F, PUSSICK F & AABY P & ROMBO L - Comparison of 3, 5 and 7 days' treatment with Quinimax for falciparum malaria in Guinea-Bissau. Trans R Soc Trop Med Hyg, 1997, 91, 462-464.
  • 5. MENAN EIH, YAVO W, OGA SSA, KIKI-BARRO PC & KASSI RR et al. - Diagnostic clinique du paludisme : part réelle de la maladie. Med Afr Noire, 2007, 54, 3, 139-144.
  • 6. MENGISTU G, DIRO E & KASSU A - Outcomes of pregnancy in severe malaria with emphasis on neurological manifestations in Gondar Hospital northwest Ethiopia. Ethiop Med J, 2006, 44, 321-330.
  • 7. Ministère de la santé et du planning familial - Taux de morbidité, Madagascar 2007. [http://www.sante.gov.mg/] (accès le 29/12/2008).
  • 8. OMS, Communicable Diseases Cluster, 1211 Geneva 27, Switzerland - Severe falciparum malaria. Trans R Soc Trop Med Hyg, 2000, 94, 1-90.
  • 9. OMS, Département Faire reculer le paludisme 2005 - Les associations thérapeutiques à base d'artémisinine (ACT). [http://www.rbm.who.int/cmc_upload/0/000/015/364/RBMInfosheet_9fr.htm] (accès le 09/02/2009).
  • 10. RANDRIANARIVELOJOSIA M, SAHONDRA-HARISOA JL, RAHARIMALALA LA, RAVELOSON A & MAUCLERE P et al. - Évaluation in vitro de la sensibilité de Plasmodium falciparum à la chloroquine dans la région de l'océan Indien dans le cadre du réseau d'étude de la résistance (RER). Cahiers Santé, 2003, 13, 95-100
  • 11. Société de pathologie infectieuse de la langue française - Prise en charge et prévention du paludisme d'importation à Plasmodium falciparum: recommandations pour la pratique clinique 2007 (révision de la Conférence de consensus 1999). Med Mal Inf, 2008, 38, 2, 68-117.
  • 12. SOUMARE M, DIOP BM, NDOUR CT, DIENG Y & NDIAYE FS et al. - Epidemiological, clinical and therapeutic aspects of severe malaria in adults in the infectious disease department of Central University Hospital of Dakar. Dakar Med, 1999, 44, 8-11.