Exchange transfusion and life-threatening malaria.

Q: Exchange transfusion is an effective treatment for life-threatening malaria.

A) Yes

B) No

Answer: B

Although theoretically, it makes sense that removing infected red blood cells and lowering the parasite load by replacing the unparasitized cells should help in severe malaria, the evidence fails to support this hypothesis. There are no differences in outcome. Although previously Centers for Disease Control and Prevention (CDC) supported this hypothesis but does not recommend exchange transfusion for treatment of severe malaria anymore.

Similarly, WHO guidelines does not make any such recommendations.

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References:

1. World Health Organization. Guidelines for malaria, 25 November 2022. https://www.who.int/publications/i/item/guidelines-for-malaria (Accessed on March 3, 2024).

2. Riddle MS, Jackson JL, Sanders JW, Blazes DL. Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: a meta-analysis. Clin Infect Dis 2002; 34:1192.

3. Tan KR, Wiegand RE, Arguin PM. Exchange transfusion for severe malaria: evidence base and literature review. Clin Infect Dis 2013; 57:923.