Blackwater Fever and Acute Renal Failure in Expatriates in Africa

From September 1976 to July 1993, 7 patients—5 Europeans, 1 Filipino national, and 1 Korean—were admitted to the Renal Unit of Korle Bu Teaching Hospital in Ghana with acute renal failure due to severe malaria and intravascular hemolysis. All these patients had been in the Tropics 3 to 8 weeks and none were on malarial prophylaxis. All needed dialysis because of severe uremic symptoms. Four patients survived and 3 died. It is recommended that nationals from nonmalarial countries be counselled on the extreme importance of malarial prophylaxis when visiting Tropical areas where malaria is endemic.