Recommendations for the management of severe malaria and severe dengue in resource-limited settings

Sepsis in resource-limited settings will often have different aetiologies to those in western settings, including severe malaria, severe dengue, viral haemorrhagic fevers, mellioidosis, typhus, and leptospirosis. The Surviving Sepsis Campaign (SSC) guidelines [1] are mainly based on evidence from studies on bacterial sepsis. These guidelines are widely applicable, but there are also exceptions. We focus here on disease-specific recommendations for the management of severe falciparum malaria and severe dengue. An international team with extensive practical experience in resource-limited intensive care units (ICUs) identified key questions concerning the SSC’s management recommendations on these diseases. Pertinent evidence from resource-limited settings was evaluated using the grading of recommendations assessment, development and evaluation (GRADE) tools.