Retrospective study of imported falciparum malaria in French paediatric intensive care units

ObjectiveThe World Health Organization (WHO) severity criteria for paediatric Plasmodium falciparum (Pf) malaria are based on studies in countries of endemic malaria. The relevance of these criteria for other countries remains unclear. We assessed the relevance of these criteria in an industrialised country.DesignRetrospective case-control study.SettingEight French university hospitals, from 2006 to 2012.PatientsChildren with Pf malaria admitted to paediatric intensive care units (cases: n=55) or paediatric emergency departments (controls: n=110).Main outcome measuresDescriptive analysis of WHO severity criteria and major interventions (mechanical ventilation, blood transfusion, fluid challenge, treatment of cerebral oedema, renal replacement therapy). Thresholds were set by receiver operating characteristics curve analysis.ResultsAltered consciousness (71% vs 5%), shock (24% vs 1%), renal failure (20% vs 1%), anaemia 50 µmol/L (25% vs 8%) and parasitaemia >10% (30% vs 8%) were more frequent in cases (p