Clinical Review

Treating severe and complicated malaria

BMJ 2004; 328 doi: (Published 15 January 2004) Cite this as: BMJ 2004;328:155
  1. Umberto D'Alessandro (, head of epidemiology unit11
  1. 1Department of Parasitology, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium

    Clinical attacks are usually uncomplicated and can be managed with an effective oral drug. Most occur in sub-Saharan Africa. Of the 200 million episodes of clinical malaria that occur each year among African children, 4-6 million are severe and life threatening, and most of the 1 million deaths from malaria worldwide are in Africa.1 Although some risk factors for severe malaria have been identified—for example, human leucocyte antigens (HLA Bw 53 is associated with protection from severe malaria), it is still unclear why only some children develop severe disease.

    The clinical manifestations of severe malaria are complex and may vary between age groups and …

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