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Volume 13, Number 6—June 2007

Research

Risk Factors for Imported Fatal Plasmodium falciparum Malaria, France, 1996–2003

Fabrice Legros*†‡§, Olivier Bouchaud¶, Thierry Ancelle#**, Amandine Arnaud*†, Sandrine Cojean#††, Jacques Le Bras¶#††, Martin Danis*†§‡‡, Arnaud Fontanet§§, Rémy Durand††¶Comments to Author , Autochthonous Malaria Epidemiology, and for the French National Reference Centers for ImportedChemosensitivity Working Group
Author affiliations: *Centre National de Référence de l'Epidémiologie du Paludisme d'Importation et Autochtone, Paris, France; †University Pierre et Marie Curie, Paris, France; ‡Institut de Recherche pour le Développement, Paris, France; §Institut National de la Santé et de la Recherche Medicalé, U511, Paris, France; ¶Hôpital Avicenne and University Paris 13, Bobigny, France; #University Paris 5, Paris, France; **Hôpital Cochin; Paris, France; **Hôpital Cochin; Paris, France; ††Centre National de Référence pour la Chimiosensibilité du Paludisme Hôpital Bichat-Claude Bernard, Paris, France; ‡‡Groupe Hospitalier Pitié-Salpêtrière, Paris France; §§Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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Table 3

Clinical data for 96 patients with fatal malaria, 1996–2003, France

Clinical data No. travelers (%)
Initial symptoms
Fever 80 (83.3)
Mental status changes 45 (46.9)
Jaundice 24 (25)
Diarrhea 18 (18.7)
Respiratory symptoms 13 (13.5)
Coma 11 (11.5)
Vomiting 9 (9.4)
Convulsions 6 (6.2)
Lethargy 5 (5.2)
Cough 4 (4.2)
Shock syndrome 4 (4.2)
Severity criteria* during clinical course
Renal failure 70 (72.9)
Shock syndrome 60 (62.5)
Cerebral malaria 55 (57.3)
Acute respiratory distress syndrome 44 (45.8)
Acidosis 36 (37.5)
Disseminated intravascular
 coagulation 30 (31.2)
Pulmonary edema 12 (12.5)
Scleral icterus 11 (11.5)
Convulsions 9 (9.4)
Other conditions
Nosocomial infection 24 (25)
Cardiac failure 49 (51)
Cerebral edema 10 (10.4)

*Severity criteria according to World Health Organization, 2000.

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