Clinical presentation & survival outcome of severe malaria among hospitalized children- a single centre observational study

Abstract

Introduction: Malaria is characterized by paroxysms of fever, chills, sweats, fatigue, anaemia& splenomegaly. Fatality rates around 10-30 % have been reported among children mainly due to cerebral malaria &anaemia followed by respiratory infections, diarrheal disease & malnutrition. Methodology: This study was done in Department of pediatrics, S.C.B medical college & S.V.P. P.G.I.P., Cuttack, from October 2013 to September 2015 with Objectives to study the clinical presentation & survival outcome of severe malaria in children of age group 1 to 14 yrs. A detailed history of illness, clinical examination, investigations, treatment & responses to therapy of each case were noted in standard proforma. Results: A total of 134 children with severe malaria were studied. Maximum number of cases were seen in age group of 1-5 years (40.29%) followed by age group of 5-10 years (33.58%). Male: Female ratio was 1.6:1.Fever was present in 100% of cases, altered sensorium in 50%, convulsion in 49% & jaundice in 35.82%. Most of the cases were due to p. Falciparum (80.59%). Out of 41cases of severe anemia, 22(53.65%) survived. Out of 8 cases with respiratory distress, 1(0.74%) survived. Out of 67 cases with CNS involvement, 45(67.16%) survived. Out of 25 cases with Hepatopathy, 25(18.65%) survived. Out of 47 cases of single organ involvement 45 cases survived & 2 cases died. Out of 60 cases of multiple organ involvement 36 cases survived. Conclusion: Awareness about the changing spectrum of severe malaria is of great importance to every level for healthcare provider.