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<datestamp>2017-12-21</datestamp>
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<publisher>HAL CCSD</publisher>
<title lang=en>Hyperparasitaemia during bouts of malaria in French Guiana.</title>
<creator>Carme, Bernard</creator>
<creator>Demar, Magalie</creator>
<contributor>Epidémiologie des parasitoses et mycoses tropicales ; Université des Antilles et de la Guyane (UAG) - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Centre d'investigation clinique Antilles-Guyane ; Institut National de la Santé et de la Recherche Médicale (INSERM) - CH Cayenne</contributor>
<contributor>Unité des Maladies Infectieuses et Tropicales (U. M. I. T.) ; Centre Hospitalier Andrée Rosemon</contributor>
<description>International audience</description>
<source>ISSN: 1475-2875</source>
<source>Malaria Journal</source>
<publisher>BioMed Central</publisher>
<identifier>inserm-00780740</identifier>
<identifier>http://www.hal.inserm.fr/inserm-00780740</identifier>
<identifier>http://www.hal.inserm.fr/inserm-00780740/document</identifier>
<identifier>http://www.hal.inserm.fr/inserm-00780740/file/1475-2875-12-20.pdf</identifier>
<source>http://www.hal.inserm.fr/inserm-00780740</source>
<source>Malaria Journal, BioMed Central, 2013, 12 (1), pp.20. 〈10.1186/1475-2875-12-20〉</source>
<identifier>DOI : 10.1186/1475-2875-12-20</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1186/1475-2875-12-20</relation>
<identifier>PUBMED : 23324618</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/23324618</relation>
<language>en</language>
<subject lang=pt>Malaria</subject>
<subject lang=pt>Plasmodium falciparum</subject>
<subject lang=pt>Plasmodium vivax</subject>
<subject lang=pt>Hyperparasitaemia</subject>
<subject lang=pt>Severe malaria</subject>
<subject lang=pt>French Guiana</subject>
<subject>[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>UNLABELLED: ABSTRACT: BACKGROUND: High circulating parasite load is one of the WHO criteria for severe falciparum malaria. During a period of 11 years (2000-2010), the frequency of hyperparasitaemia (HP) (≥4% infected erythrocytes) during bouts of malaria due to Plasmodium falciparum, Plasmodium vivax and Plasmodium malariae in patients referred to Cayenne General Hospital (CGH) in French Guiana and the frequency of their admission to the Intensive Care Unit (ICU) were evaluated. METHODS: A mean of 1,150 malaria cases were referred to the Parasitology Laboratory of CGH each year over the last decade. During this period, malaria diagnostic (microscopy) and parasitaemia evaluation have remained unchanged: determination of the parasitized erythrocytes percentage with asexual forms on thin blood smears for all cases of parasitaemia exceeding 0.1%. Patients admitted to the ICU can be counted by origin of the request for malaria testing. All the data collected retrospectively were anonymized in a standardized case report form and in database. RESULTS: Between 2000 and 2010, 12,254 bouts of malaria were confirmed at the Parasitology Laboratory of CHG: P. vivax: 56.2%, P. falciparum: 39.5%, co-infection with both species: 3.4%, P. malariae: 0.9%. HP was observed in 262 cases, at a frequency of 4.9% for P. falciparum and only 0.041% for P. vivax, with no recorded cases for P. malariae. The need for intensive care was correlated with P. falciparum parasite load: 12.3% of cases for parasitaemia of 4-9%, 21.2% for parasitaemia 10-19%, 50% for parasitaemia 20-29% and 77.8% for parasitaemia ≥30% (n=9). The patient with the highest parasitaemia (75% infected erythrocytes with asexual form) presented a major concomitant lupus flare-up treated with corticoids. He survived without obvious sequelae. CONCLUSIONS: In French Guiana during bouts of malaria, HP was observed at a frequency of ~ 5% for P. falciparum and two orders of magnitude less frequent for P. vivax. HP is a severity criterion for falciparum malaria in this endemic area. However, two of the patients with HP ≥30% were not admitted to the ICU and sequel-free cure in malaria patients with 75% parasitaemia is, therefore, possible.</description>
<date>2013</date>
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