Clinical profile and outcome of severe P. Falciparum malaria

Abstract

INTRODUCTIONMalaria 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.1 In India, during 2011, the malaria incidence was around 1.31 million cases, 0.67 million P. falciparum (Pf) cases and 754 deaths while during 2014 (till October), 0.85 million cases, 0.54 Pf cases and 316 deaths have been reported. 2Malaria is a public health problem in several parts of the country. About 95% population in the country resides in malaria endemic areas and 80% of malaria reported in the country is confined to areas consisting of 20% of population residing in tribal, hilly, difficult and inaccessible areas. Majority of studies of malaria are from endemic or hyper endemic areas of India. This study is of malaria in a tertiary care center in South Maharashtra, a hypo endemic area for falciparum malaria. The number of atypical presentations of malaria has gradually increased during the past few decades. Several factors have been attributed to increased morbidity and mortality in malaria with altered hematological and coagulation parameters, playing an important role. ABSTRACTBackground: 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.

Retrospective Analysis of Cases with Imported Malaria in Hatay Province of Turkey: Seventy-Five Cases in Ten Years

“…Bu veriyi destekler şekilde çalışmamızda ABY gelişmiş olguların hiçbirinde ciddi seyirli sıtma gelişimi gözlenmemiştir. Sarılık, yetişkinlerde ciddi seyirli sıtmanın en yaygın görülen bulgularından biridir (23). Sıtma olgularında sarılık varlığının daha yüksek komplikasyon oranlarını ve daha şiddetli enfeksiyon gelişimini işaret ettiği düşünülmektedir (24).…”