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on of sterility protocol with anti-malaria prophylaxis led to improvements in our centre's outcomes. The management of POF in the cardiac ICU was complicated by the requirement of co-operation from a larger number of specialties than is usually required in advanced centres with special expertise in malaria confirmation. We, therefore, introduced structured clinical, laboratory, and appropriate interventions to treat POF more aggressively. We found that more careful attention to peri-operative details to ensure strict observation of sterili