Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium

Malaria Journal

Table 4 Outcome

Endpoint	Number of patients (n = 68)
Mortality, n (%)
among severe malaria,% (n = 55)	2* (3.6)
Mean parasite clearance times (95% CI), hours^†
PCT_50%	4.4 (3.9 - 5.2)
PCT_90%	14.8 (13.0 - 17.2)
PCT_99%	29.5 (25.9 - 34.4)
ICU admittance, n (%)	42 (62)
Median duration of ICU stay (range), days	2 (1-35)
Median duration of hospital stay (range), days	4.5 (1-76)

PCT50%, PCT90%, and PCT99% are the parasite clearance times, defined as the time (in hours) to obtain a 50%, 90%, and 99% reduction in parasite count after start of artesunate treatment, respectively
* One patient still suffered from a delirious state and in an unobserved moment he inadvertently removed his haemofiltration catheter from the femoral vein. He died due to a loss of blood. A second patient died shortly after sudden collapse during defecation and pulmonary embolism was suspected but not confirmed as autopsy was not permitted. It occurred while the patient was treated with subcutaneous low molecular weight heparin
^† Calculated from 57 patients with the following conditions:
■ the limit of detection was set at 10 parasites/μL. Non detectable parasite counts were not included in the log linear effects model
■ when more than one slide was made before artesunate treatment was given, the oldest slides were excluded from analysis. The value nearest to T₀ was used
■ for repeated parasite counts around the detection limit, only the first value was included in the model
■ Malaria cases caused by other species than P. falciparum were excluded for estimation of parasite clearance rates
■ In most patients (88%) parasite counts were performed at least twice in the first 24 hours (range 1-7 times)

ISSN: 1475-2875