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close this bookGuidelines for the Treatment of Malaria (WHO; 2006; 266 pages) View the PDF document
View the documentGlossary
View the documentAbbreviations
open this folder and view contents1. Introduction
View the document2. The clinical disease
open this folder and view contents3. Treatment objectives
open this folder and view contents4. Diagnosis of malaria
open this folder and view contents5. Resistance to antimalarial medicines9
open this folder and view contents6. Antimalarial treatment policy
open this folder and view contents7. Treatment of uncomplicated P. Falciparum malaria10
close this folder8. Treatment of severe falciparum malaria14
View the document8.1 Definition
View the document8.2 Treatment objectives
View the document8.3 Clinical assessment
View the document8.4 Specific antimalarial treatment
View the document8.5 Practical aspects of treatment
View the document8.6 Follow-on treatment
View the document8.7 Pre-referral treatment options16
View the document8.8 Adjunctive treatment
View the document8.9 Continuing supportive care
View the document8.10 Additional aspects of clinical management
View the document8.11 Treatment during pregnancy
View the document8.12 Management in epidemic situations
View the document8.13 Hyperparasitaemia18
open this folder and view contents9. Treatment of malaria caused by P. vivax, P. ovale or P. malariae19
View the document10. Mixed malaria infections
open this folder and view contents11. Complex emergencies and epidemics
open this folder and view contentsAnnexes

8.1 Definition

In a patient with P. falciparum asexual parasitaemia and no other obvious cause of their symptoms, the presence of one or more of the following clinical or laboratory features classifies the patient as suffering from severe malaria15:

Clinical manifestation:

- Prostration
- Impaired consciousness
- Respiratory distress (acidotic breathing)
- Multiple convulsions
- Circulatory collapse
- Pulmonary oedema (radiological)
- Abnormal bleeding
- Jaundice
- Haemoglobinuria

Laboratory test:

- Severe anaemia
- Hypoglycaemia
- Acidosis
- Renal impairment
- Hyperlactataemia
- Hyperparasitaemia

15 Full details of the definition and prognostic factors are provided in WHO Severe falciparum malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene, 2000:94(Suppl. 1):1-90, and Management of severe malaria: a practical handbook, 2nd ed. Geneva, World Health Organization, 2000.


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