Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: a meta-analysis

Clin Infect Dis. 2002 May 1;34(9):1192-8 doi: 10.1086/339810.

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.

MESH HEADINGS: Adolescent; Adult; Animals; Antimalarials; Exchange Transfusion, Whole Blood; Humans; Malaria, Falciparum; Plasmodium falciparum; Survival Rate
Study Details
Study Design: Systematic Review
Credits: Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine