OBJECTIVE: To compare the efficacy of exchange transfusion as the adjunct to quinine treatment (21 patients) with quinine therapy alone (29 patients). METHOD: A retrospective study of 50 patients with severe falciparum malaria was conducted at Chumphorn Hospital, Southern Thailand. RESULTS: Clinical characteristics in both treatment groups were not significantly different although in the exchange transfusion group, the admission geometric mean parasitaemia (18 (5%), and the proportion of patients with more than 10% parasitaemia was higher (76%, P = 0.03) than in the group who received quinine alone (10 +/- 4%; 38%, P = 0.1). The mortality rate of patients who received exchange transfusion was 48%; that of the remainder, 69%. (P = 0.3). ARDS (P = 0.01) and oliguric renal failure (P = 0.04) were significant risk factors for death in these patients. CONCLUSION: Exchange transfusion was safe and well tolerated. Results of our study revealed a 20% reduction in mortality when exchange transfusion was used as an adjunct to quinine treatment. It should therefore be considered in patients with severe falciparum malaria when possible.
OBJECTIVE: To compare the efficacy of exchange transfusion as the adjunct to quinine treatment (21 patients) with quinine therapy alone (29 patients). METHOD: A retrospective study of 50 patients with severe falciparum malaria was conducted at Chumphorn Hospital, Southern Thailand. RESULTS: Clinical characteristics in both treatment groups were not significantly different although in the exchange transfusion group, the admission geometric mean parasitaemia (18 (5%), and the proportion of patients with more than 10% parasitaemia was higher (76%, P = 0.03) than in the group who received quinine alone (10 +/- 4%; 38%, P = 0.1). The mortality rate of patients who received exchange transfusion was 48%; that of the remainder, 69%. (P = 0.3). ARDS (P = 0.01) and oliguric renal failure (P = 0.04) were significant risk factors for death in these patients. CONCLUSION: Exchange transfusion was safe and well tolerated. Results of our study revealed a 20% reduction in mortality when exchange transfusion was used as an adjunct to quinine treatment. It should therefore be considered in patients with severe falciparum malaria when possible.