Journal Article

Exchange Transfusion as an Adjunct Therapy in Severe <i>Plasmodium falciparum</i> Malaria: A Meta-analysis

Mark S. Riddle, Jeffrey L. Jackson, John W. Sanders and David L. Blazes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 9, pages 1192-1198
Published in print May 2002 | ISSN: 1058-4838
Published online May 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/339810
Exchange Transfusion as an Adjunct Therapy in Severe Plasmodium falciparum Malaria: A Meta-analysis

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The efficacy of exchange transfusion as an adjunct treatment for severe falciparum malaria is controversial. No sufficiently powered, randomized, controlled study has been reported. We analyzed 8 studies that compared survival rates associated with adjunct exchange transfusion with those associated with antimalarial chemotherapy alone. Exchange transfusion was not associated with a higher survival rate than was antimalarial chemotherapy alone (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.7–2.1). However, patients who received transfusions had higher levels of parasitemia and more-severe malaria. Sensitivity analysis found that survival rates were higher among patients with partial immunity to malaria (OR, 0.5; 95% CI, 0.2–1.2) than they were among patients with no immunity (OR, 2.1; 95% CI, 0.9–4.8; P = .007). Exchange transfusion does not appear to increase the survival rate; however, there were significant problems with the comparability of treatment groups in the studies reviewed, and a randomized controlled trial is necessary to determine whether exchange transfusion is beneficial.

Journal Article.  3954 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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