Clinical profile and outcome of severe P. Falciparum malaria
DOI:
https://doi.org/10.18203/2349-3933.ijam20163744Keywords:
Clinical profile, Jaundice, Malaria, Plasmodium falciparumAbstract
Background: Malaria is a public health problem in more than 90 countries. According to the latest estimates of WHO, released in December 2015, there were 214 million cases of malaria in 2015 and 438 000 deaths. The aim was to study clinical profile and outcome of severe falciparum malaria in patients at tertiary health care centre.
Methods: In this prospective study, total 125 clinically diagnosed severe malaria cases admitted during period of November 2013 to October 2015, were enrolled excluding patients below 12 years of age. Detailed history and clinical examination was carried out to assess clinical severity and complications of malaria.
Results: Of the 125 cases studied 110 cases were of severe malaria produced by Plasmodium falciparum infection diagnosed on peripheral smear examination or by antigen detection test. The remaining 15 cases were excluded from the study. In this study, seventy six (69.1%) cases were males and thirty four (30.9%) cases were females, with male: female ratio of 2.23:1. Common symptoms found were fever, chills and rigors, altered sensorium, jaundice and nausea or vomiting while most common complication was jaundice, seen in 45.45%. Mortality due to severe falciparum malaria observed was 13.63%.
Conclusions: In this study of severe falciparum malaria, most common symptoms found were fever, chills and rigors, altered sensorium, jaundice, nausea and vomiting while most common signs were pallor, splenomegaly, icterus, hepatomegaly, bleeding tendencies and in a few cases neck stiffness and hypotension. Jaundice, renal failure, impaired consciousness and cerebral malaria were most common complications of severe falciparum malaria.
References
WHO, Fact sheet no. 94, Recent advances in research and development of malaria. 2015.
Govt. of India. Malaria, Magnitude of the problem NVBDCP, DGHS, Ministry of Health and Family Welfare, New Delhi. 2015.
World Health Organization (WHO). Guidelines for the treatment of malaria Geneva, Switzerland: WHO, 2010.
World Health Organization (WHO). Malaria rapid diagnostic test performance. Results of WHO product testing of malaria RDTs: round 2 (2009). Geneva, Switzerland: WHO, 2010.
WHO Guidelines for the treatment of malaria. Third edition. 2015.
Mishra SK, Mohanty S, Satpathy SK, Mohapatra DN. Cerebral malaria in adults - a description of 526 cases admitted to Ispat General Hospital in Rourkela, India. Ann Trop Med Parasitol. 2007;101(3):187-93.
Murthy GL, Sahay RK, Srinivasan VR, Upadhaya AC, Shantaram V, Gayatri K. Clinical profile of falciparum malaria in a tertiary care hospital. J Indian Med Assoc. 2000;98(4):160-9.
Visith S. Nephropathy in falciparum malaria. Kidney International. 1988;34:867-77.
Barsoum RS. Malarial acute renal failure. J Am Soc Nephrol. 2000;11:2147.
Kochar D, Kumawat BL, Karan S. Severe and complicated malaria in Bikaner, western India”. Southeast Asian J Tropical Med. 1997;28(2):259-67.
Patil V. Complicated falciparum Malaria in western Maharashtra. Trop Parasitol. 2012;2(1):49-54.
Warrell DA, Molyneux ME, Beasles PF. Severe and complicated malaria. Trans Roy Soc Trop Med Hyg 1990;84:1.
Wasnik PN, Manohar TP, Humaney NP, Salkar HR. Study of clinical profile of falciparum malaria in a tertiary referral centre in central india. j assoc physicians India. 2012;60:33-6.
White NJ. Malaria. Manson’s Tropical Disease. 22nd editionn. London: Saunders Elsevier. 2009:1201-81.
