%0 Journal Article
%T Malaria prevention reduces in-hospital mortality among severely ill tuberculosis patients: a three-step intervention in Bissau, Guinea-Bissau
%A Raffaella Colombatti
%A Martina Penazzato
%A Federica Bassani
%A Cesaltina Vieira
%A Antonia Louren£¿o
%A Fina Vieira
%A Simone Teso
%A Carlo Giaquinto
%A Fabio Riccardi
%J BMC Infectious Diseases
%D 2011
%I BioMed Central
%R 10.1186/1471-2334-11-57
%X Since 2005 Permethrin treated bed nets were given to every patient. Since 2006 environmental prevention with permethrin derivates was performed both indoor and outdoor during the rainy season. In 2007 cotrimoxazole prophylaxis was added during the rainy season. Care was without charge; health education on malaria prevention was performed weekly. Primary outcomes were death, discharge, drop-out.427, 346, 549 patients were admitted in 2005, 2006, 2007, respectively. Mortality dropped from 26.46% in 2005 to 18.76% in 2007 (p-value 0.003), due to the significant reduction in rainy season mortality (death/discharge ratio: 0.79, 0.55 and 0.26 in 2005, 2006 and 2007 respectively; p-value 0.001) while dry season mortality remained constant (0.39, 0.37 and 0.32; p-value 0.647). Costs of malaria prevention were limited: 2?/person. No drop-outs were observed. Health education attendance was 96-99%.Malaria prevention in African tertiary care hospitals seems feasible with limited costs. Vector control, personal protection and cotrimoxazole prophylaxis seem to reduce mortality in severely ill TB patients. Prospective randomized trials are needed to confirm our findings in similar settings.Current Controlled Trials: ISRCTN83944306Malaria and Tuberculosis are important causes of morbidity and mortality in Africa [1] and are among the main reasons of hospital admission and in-hospital mortality [2-5]. During the rainy season, malaria burden increases [6-8] in many African countries, peaking morbidity and mortality. Regardless of HIV status, malaria infection affects severely ill TB patients who are already compromised by malnutrition, deprived immunity or disseminated disease [6,9,10]. In fact, in pulmonary TB there is a transient systemic immunosuppression due to over expression of transforming growth factor beta and interleukin-10 [11]. Interactions between TB and malaria have been demonstrated both in vitro and in vivo: Plasmodium Falciparum modulates Mycobacterium Tuberculosis i
%U http://www.biomedcentral.com/1471-2334/11/57