Malaria. A challenge for the haemodialysis and intensive care nurse.

Malaria is the world's most important tropical parasitic disease. In many developing countries, and Africa in particular, malaria exacts an enormous toll in lives, medical costs, and days of lost labour. Through the use of case studies, this paper explores the effects of malaria and the patient management by the haemodialysis and intensive care nurse. All malaria cases admitted to an intensive care unit, and treated by means of haemodialysis or continuous-veno-veno-haemodiafiltration were analysed. Specific problems identified were impaired fluid and biochemical control, acid-base imbalance, disseminated intra vascular coagulation, adult respiratory distress syndrome, and haemodynamic instability. Guidelines were compiled for the nursing management of these complicated malaria cases.