Clinical pattern of severe Plasmodium falciparum malaria in Sudan in an area characterized by seasonal and unstable malaria transmission

Abstract

A hospital-based study was carried out in Gedarif town, eastern Sudan, an area of markedly unstable malaria transmission. Among the 2488 diagnosed malaria patients, 4.4% fulfilled the WHO criteria for severe malaria, and seven died of cerebral malaria. The predominant complication was severe malarial anemia (45.4%), followed by convulsions (21%), cerebral malaria (16. 4%) and hypotension (11.8%). Severe malaria was recognized in all age groups, but 44.5% of patients were aged 2 to 4 years. The mean ages of patients with severe anemia (5.6 years) and convulsions (5.9 years) were significantly lower than the mean ages of patients with cerebral malaria (14.1 years) or hypotension (35.2 years). Patients with convulsions and cerebral malaria had significantly higher mean parasite count (69972 and 56110 parasites/microL, respectively) than patients with severe anemia (24637 parasites/microL) or hypotension (13667 parasites/microL). The mean blood glucose level was higher in patients with cerebral malaria than in patients with anemia, and higher in patients who died than in patients who survived. In this setting, the clinico-epidemiological pattern of severe malaria varies considerably from that of hyperendemic regions in sub-Saharan Africa, and there is considerable variation between the individual complications of severe malaria.

Allelic polymorphism of MSP2 gene in severe P. falciparum malaria in an area of low and seasonal transmission

“…We found no correlation between MOI and age, unlike in previous reports from malaria-hyperendemic regions (Konate et al 1999;Ntoumi et al 1995). However, in this area, both UM and SM affect all age groups, but SM is more common in younger patients (Giha et al 2005). Furthermore, there was no correlation between pretreatment parasitemia and clone number as mentioned in other studies (Henning et al 2004).…”

“…This study was carried out over two consecutive malaria seasons (September-January), between 2000 and 2002. The clinical and epidemiological pattern of SM was presented elsewhere (Giha et al 2005). The P. falciparum is the predominant species (98%), and the Anopheles arabiensis is the sole vector.…”

The profile of IgG-antibody response against merozoite surface proteins 1 and 2 in severe Plasmodium falciparum malaria in Eastern Sudan

“…The moderate, seasonal, and markedly unstable Plasmodium falciparum malaria infection is transmitted mainly by Anopheles arabiensis, and the entomological inoculation rate (EIR) is very low. The clinical patterns of SM in the area have been previously reported (Giha et al 2005). …”

Study of Platelet Count in Malaria Patients and the Correlation Between the Presence and Severity of Platelet Count With Type of Malaria

“…The commonest clinical manifestation was fever with chills and rigors (100%), headache (25.5%)'vomiting (22.2%) jaundice (15.5%). 8 Commonest sign being splenomegaly (86.7%) followed by pallor (46.7%) and icterus (13.3%) . These findings are comparable with other studies like Oh MD et al, Song HH et al Giha HA et al Grobusch MP et al Trampuz A et al who found that fever with chills was the most common symptom found followed by headache, vomiting and jaundice.…”