Background/Objectives: Severe malaria poses a significant public health concern in Angola, particularly among adults. This study assessed the clinical manifestations and outcomes of severe Plasmodium falciparum malaria in adult patients admitted to Hospital Central Dr. António Agostinho Neto of Lubango (HCL), Angola. Methods: The study retrospectively reviewed medical records of patients over 14 years old admitted with severe malaria during the first quarter of 2021 and 2022, coinciding with the peak transmission season. The World Health Organization (WHO) criteria were used to clarify the disease severity. The cohort included 640 patients—167 in 2021 and 473 in 2022—distributed across the following departments: the Intensive Care Unit (ICU; n = 81), Medicine (MED; n = 458) and Infectiology (INF; n = 101). Results: The median age was 26 years and 59.4% were males. Renal impairment was the most frequent severe manifestation, affecting 37.4% of cases. The mortality rate across the study period was 7%, showing a notable decrease from 10.2% in 2021 to 5.9% in 2022. The higher mortality rate in 2021 may reflect the impact of the COVID-19 pandemic, which limited hospital access and delayed care, resulting in more critical cases being admitted at a later stage. In 2022, with reduced COVID-19 pressures, earlier access to treatment may have improved outcomes, contributing to the lower mortality rate. Conclusions: This study emphasizes the need to assess the clinical burden of severe malaria in low-endemic regions, where shifting patterns may signal emerging threats such as antimalarial drug resistance. Further research is essential to optimize control strategies and strengthen surveillance systems, reducing morbidity and mortality.

Severe Plasmodium falciparum malaria remains the primary cause of mortality in several African countries, including Angola, where severe malaria patient admission into intensive care units (ICU) is mandatory. The present observational and prospective study enrolled 101 consecutive severe malaria patients admitted at the ICU of Américo Boavida University Hospital (Luanda, Angola). Malaria was confirmed by microscopy and RDT, and WHO criteria were used to define severe malaria. The Sequential Organ Failure Assessment (SOFA) score was used to monitor organ dysfunctions. Surviving and nonsurviving patients were compared using bivariate statistical methods. Two-step cluster analysis was used to find discriminant organ dysfunctions that may correlate better with the observed mortality (16.8%), which was much lower than the one generated by the SOFA score. The study population was young, and 87% of the patients were local native residents. There was no statistically significant correlation between the parasitemia and the outcome. Hematological and cerebral dysfunctions were prevalent but were not discriminant when cluster analyses were performed to detect homogeneous subgroups of patients. In conclusion, the SOFA score was readily applicable and efficient in monitoring daily organ dysfunction but was not effective enough in predicting the outcome of severe malaria patients.

Background: Nearly 30 years since its inception, the early warning scores (EWSs) remain pivotal, yet variations have emerged for hospital and prehospital use. Aggregated scores, reflecting multiple physiological parameters, outperform single‐parameter systems in assessing acute illness severity, though consensus on optimal approaches is lacking. Resource‐limited countries, including Angola, lack adapted EWSs, emphasizing the need for cost‐effective and adaptable solutions to enhance patient care.Objective: To explore the perspectives of Angolan experts to identify physiological parameters suitable for incorporation into existing EWSs, allowing the development of a new tool adjusted to the healthcare context in Angola.Methods: We conducted a three‐round Delphi survey, engaging a national expert panel comprising twenty‐five physicians and nurses with expertise in internal medicine, surgery, emergency rooms, intensive care units, and/or teachers at universities or at teaching courses in these fields. Participants were asked to rate items using a five‐point Likert scale. Consensus was achieved if the items received a rating ≥ 80% from the panel.Results: Consensus was evident for the inclusion of standard physiological parameters, such as systolic blood pressure, heart rate, respiratory rate, temperature, oxygen saturation, neurological status, and the presence or absence of supplemental oxygen. Furthermore, there was consensus for the consideration of specific items, namely, seizures, jaundice, cyanosis, capillary refill time, and pain—typically not included in the current EWSs. Consensus was reached regarding the exclusion of both oxygen saturation and temperature measurements in healthcare settings where oximeters and thermometers might not be readily available.Conclusion: Angolan experts were able to identify the physiological parameters suitable for incorporation into the basic EWSs. Further study must be conducted to test and validate the impact of the newly suggested vital parameters on the discriminant and predictive capability of a new aggregated model specifically adjusted to the Angolan healthcare setting.

Artemisinin-based combination therapies (ACTs) are the cornerstone of treatment for uncomplicated Plasmodium falciparum malaria in Angola. The Ministry of Health conducts therapeutic efficacy studies (TES) at sentinel sites to monitor treatment effectiveness and detect emerging antimalarial drug resistance. This study systematically reviewed the therapeutic efficacy and safety of ACTs used in Angola from 2006 to December 2025. A systematic literature search was conducted in PubMed to identify clinical studies evaluating the efficacy and safety of ACTs, including artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), dihydroartemisininpiperaquine (DP) and artesunate-pyronaridine (ASPY), for the treatment of uncomplicated P. falciparum malaria in Angola. Of 913 records identified, seven studies from Bengo, Benguela, Luanda, Lunda Sul, Uíge, and Zaire met the inclusion criteria. ACTs showed high therapeutic efficacy, with PCR-corrected adequate clinical and parasitological response (ACPR) generally exceeding 90% through 42 days of followup. However, AL efficacy was below 90% in Zaire in 2013, 2015, Lunda Sul in 2019, and Bengo in 2021, whereas AS-AQ and DP consistently maintained high efficacy. Molecular surveillance showed no evidence of established artemisinin resistance, although markers potentially associated with reduced lumefantrine susceptibility warrant continued monitoring. Adverse events were predominantly mild and transient. ACTs remain effective and well tolerated for uncomplicated P. falciparum malaria in Angola. Nevertheless, recurrent reductions in AL efficacy at specific sentinel sites highlight the need for sustained therapeutic efficacy and molecular surveillance through regular TES to enable early detection of emerging antimalarial resistance and inform national treatment policies.

Introducción: Las malformaciones linfáticas cervicales son anomalías congénitas que pueden presentar complicaciones perinatales, lo cual representa un reto terapéutico, especialmente en casos con ruptura de la lesión. Presentación del caso: Recién nacida de 38 semanas con lesión cervical izquierda de aproximadamente 5 cm, con ruptura y drenaje de contenido seroso al nacimiento. Se realizó tratamiento escalonado mediante necrectomía y cierre del defecto para lograr la hermeticidad de los quistes, seguido de escleroterapia con bleomicina. La paciente presentó evolución clínica favorable, con disminución progresiva de la lesión y resolución completa tras una única intervención, sin complicaciones. Conclusiones: La ruptura neonatal constituye una presentación infrecuente que requiere manejo individualizado. El abordaje escalonado permite un tratamiento seguro y la bleomicina es una opción terapéutica eficaz.

Severe malaria is a major public health concern in Angola, particularly among adults, with limited data on clinical outcomes and manifestations. The study therefore assessed the clinical manifestations and outcome of severe Plasmodium falciparum malaria in adult patients admitted to Hospital Central Dr. António Agostinho Neto of Lubango, Angola. The study retrospectively reviewed the individual records of patients over 14 years old, admitted for severe malaria during the first trimester of 2021 and 2022. World Health Organization (WHO) criteria were used to define severity. A total of 640 patients were recorded into the study, 167 in 2021 and 473 in 2022, distributed across the departments; Intensive Care Unit (ICU; n=81), Medicine (MED; n=458) and Infectiology (INF; n=101). The median age was 26 years and 59.4% were males. The most common manifestation of severe malaria was renal impairment (37.4%). The overall mortality rate was 7% and decreased considerably from 10.2% in 2021 to 5.9% in 2022. The increase in malaria cases during 2022 with increased in prevalence of life-threatening signs like renal impairment, jaundice and impaired conscience, underscores the urgent need for enhanced malaria control and surveillance strategies to mitigate morbidity and mortality, highlighting the potential for antimalarial drug resistance.