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Review
. 2023 Nov 3;4(1):3-15.
doi: 10.1016/j.jointm.2023.09.002. eCollection 2024 Jan.

Diagnosis and management of malaria in the intensive care unit

George Akafity  1 , Nicholas Kumi  2 , Joyce Ashong  3
Affiliations
Review

Diagnosis and management of malaria in the intensive care unit

George Akafity et al. J Intensive Med. .

Abstract

Malaria is responsible for approximately three-quarters of a million deaths in humans globally each year. Most of the morbidity and mortality reported are from Sub-Saharan Africa and Asia, where the disease is endemic. In non-endemic areas, malaria is the most common cause of imported infection and is associated with significant mortality despite recent advancements and investments in elimination programs. Severe malaria often requires intensive care unit admission and can be complicated by cerebral malaria, respiratory distress, acute kidney injury, bleeding complications, and co-infection. Intensive care management includes prompt diagnosis and early initiation of effective antimalarial therapy, recognition of complications, and appropriate supportive care. However, the lack of diagnostic capacities due to limited advances in equipment, personnel, and infrastructure presents a challenge to the effective diagnosis and management of malaria. This article reviews the clinical classification, diagnosis, and management of malaria as relevant to critical care clinicians, highlighting the role of diagnostic capacity, treatment options, and supportive care.

Keywords: Antimalarials; Antimicrobial resistance; Artemisinin-based combination therapy; Intensive care unit; Malaria; Severe malaria.

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Figures

Figure 1
Figure 1
Life cycle of Plasmodium.[4,9] Image from the Centers for Disease Control and Prevention (www.cdc.gov) Public Health Library (PHL) and provided by CDC – DPDx/Alexander J. da Silva, Melanie Moser. Available via license: CC BY 4.0.
See this image and copyright information in PMC

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