Study of clinical profile of falciparum malaria in a tertiary referral centre in Central India (original) (raw)
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Journal of Clinical and Scientific Research, 2017
Background: Sparse published data are available regarding clinical presentation and complications of falciparum malaria from Andhra Pradesh state. Methods: In this prospective, observational study conducted during the period November 2012 to June 2014 at our teaching hospital in Kuppam, Andhra Pradesh, adult patients (n=96) admitted with fever confirmed to be suffering from falciparum malaria based on peripheral blood smear examination and / or malaria antigen test positive by rapid diagnostic test were studied. The clinical presentation and various complications of falciparum malaria were documented. Results: The male to female ratio was 2:1. Majority of the patients (70%) were in the age group 26-60 years. Fever was present in all cases. Splenomegaly (66%) was the most common physical sign followed by pallor (31%) and icterus (22%). Anaemia (51%), was the most common complication, followed by cerebral malaria (33.3%), acute respiratory distress syndrome (ARDS) (32.3%), acute kidney injury (AKI) (29.2%), and jaundice (25%). Majority of the patients presented with multiple complications (73%) than single complication (27%). Artemesinin-based combination therapy was administered to 72 of the 96 patients of whom 43 patients recovered. Quinine therapy was given to 14 patients of whom 10 recovered. Quinine plus ACT combination therapy was given to 10 patients and 7 recovered. seven of the 96 patients died; and 29 out of 96 patients were taken home against medical advice. Overall 36/96 (37.5%) patients had a poor outcome. All 7 patients who expired had multiple complications. Mortality was higher in patients who had co-existent AKI, hypotension and cerebral malaria. Conclusion: Early identification of high risk cases and institution of prompt treatment can reduce the mortality rate in falciparum malaria.
IOSR Journals , 2019
STUDY POPULATION: Study was done on admitted cases of patients above 18yrs suffering from P.falciparum malaria who have been confirmed either by peripheral blood film or rapid diagnostic tests in Medicine Department of RIMS. INCLUSION CRITERIA :All malaria cases satisfying at least one or more parameters of criteria such as unconsciousness, convulsions, high grade fever, anaemia, shock, increased serum creatinine and urea, oliguria, jaundice, hepatomegaly, splenomegaly, vomiting, abdominal pain, bleeding from abnormal site, headache were considered as complicated malaria cases. Respondent: In unconscious and severely ill non co-operative patients respondent were their attendants. SAMPLING PROCEDURE: Every consecutive case satisfying the inclusion criteria was studied. SAMPLE SIZE: 52 cases studied during the time period.
Clinical Spectrum of Severe Plasmodium falciparum Malaria in a Tertiary Care Centre of Eastern India
Introduction: Plasmodium falciparum malaria is one of the major public health problem presented with varied clinical severity. This study was carried out to observe the clinical spectrum of severe falciparum malaria in a tertiary health care centre. Methods: This study was undertaken in hospitalized adults with suspected severe malaria. Confirmation of falciparum infection was done by ICT/QBC and single-step-PCR. Diagnosis of severe malaria was done by WHO-guideline 2010. Original Research Article Purohit et al.; IJTDH, 12(4): 1-11, 2016; Article no.IJTDH.22387 2 Results: 450 adult cases with falciparum infection were studied. Maximum number of cases was from 15-25 years age group depicting the high exposure to malaria. In these patients, acute renal failure (ARF) was the most common (36.2%) complication followed by cerebral malaria (35.3%), jaundice (27.8%), hepatic dysfunction (21.8%), respiratory distress (18.4%), severe malarial anemia (15.8%), thrombocytopenia (15.1%), and hypoglycemia (9.3%). Mortality was found in 6.0% of cases. Cerebral involvement and ARF were the common cause of death in these patients. Conclusion: ARF is the most common type of clinical severity followed by cerebral malaria in adults and both are equally responsible for death along with other complications. Looking into the matter of varied clinical severity, accurate diagnosis, effective anti-malarial treatment along with supportive therapy is necessary to triumph over this deadly severe falciparum malaria.
The changing spectrum of severe falciparum malaria: a clinical study from Bikaner (northwest India)
Journal of vector borne diseases, 2006
Recently there were reports from all over India about changing spectrum of clinical presentation of severe malaria. The present study was planned to study the same in the northwest India. This prospective study was conducted on patients of severe malaria admitted in a classified malaria ward of a tertiary care hospital in Bikaner, Rajasthan (northwest India) during 1994 and 2001. It included adult patients of both sexes belonging to all age groups. The diagnosis of Plasmodium falciparum was confirmed by demonstrating asexual form of parasites in peripheral blood smear. All patients were treated with i.v./oral quinine. The specific complications were treated by standard WHO protocol. The data for individual complications for both the years were analysed by applying chi-square test. In a prospective study in 1994 the spectrum of complication was dominated by cerebral malaria (25.75%) followed by jaundice (11.47%), bleeding tendencies (9.59%), severe anaemia (5.83%), shock (5.26%), Acu...
International Journal of Advances in Medicine, 2016
Malaria continues to be one of the important public health problems in India. As per World Health Organization report 2015, South East Asian Region bears the second largest burden of malaria (10%), only being next to African region (88%).Malaria caused 214 million infections and 438000 deaths worldwide, most of them occurred in the Africa region (90%) followed by SEA Region (7%). 1 Among Southeast Asia region, India shares two-thirds of the burden (66%) followed by Myanmar (18%) and Indonesia (10%). 2 The malaria situation remains a major problem in certain states and geographical pockets. The majority of malaria cases and deaths in India are being reported from Orissa, Rajasthan, Jharkhand, Chhattisgarh, Madhya Pradesh and the Seven North Eastern states. 3 Malaria is caused by protozoan parasite of genus plasmodium. Five species of the plasmodium P. Falciparum, P. Vivax, P. Ovale, P. Malariae and P. Knowlesi cause malaria in humans. Infection is initiated when sporozoites from the salivary glands of a female anopheles mosquito are inoculated during a blood meal into the human blood stream. 4 The common clinical manifestation are fever with chills and rigors, headache, vomiting, jaundice and common sign being splenomegaly, pallor, and icterus. 13,22-23 Hematological abnormality which is most commonly seen in malaria is thrombocytopenia followed by anemia. Both are seen ABSTRACT Background: Malaria continues to be one of the important public health problems in India. As per World Health Organization report 2015, South East Asian Region bears the second largest burden of malaria (10%), only being next to African region (88%).The present study is aimed at to study clinical profile and complications, in a tertiary care hospital. Methods: A total of 100 cases were included in the study that admitted at NMCH, Kota and identified positive for malaria parasites on peripheral smear examination with conventional microscopy and / or by rapid diagnostic test. Results: predominant symptoms were fever (100%), vomiting (52%), headache (34%), myalgia (28%) and jaundice (27%) and signs were splenomegaly (75%), pallor (57%), icterus (28%), hepato-splenomegaly (19%), and hepatomegaly (04%). In this study, 82% patients suffered from uncomplicated malaria and 18% from complicated malaria. Conclusions: Malaria is responsible for major health concern in Southeastern region of Rajasthan and is found to affect comparatively the younger adult population. P. Vivax was the major parasite type causing malaria and most of the complications were due to P. falciparum.
The Study Spectrum of Falciparum Malaria in Children at MGM Hospital, Warangal
Journal of Evidence Based Medicine and Healthcare, 2016
BACKGROUND In view of the increase in the incidence of falciparum malaria in our area, most of the patients coming from malaria endemic areas, to know the spectrum of malaria in a district level teaching hospital, we have taken up this subject. METHODS It was a Prospective Observational Study during the years July 2013 to July 2015. All children with clinical suspicion of malaria between age group of 0-12 years were admitted in paediatric ward. RESULTS During the period of study in 2 years, we have observed that there is progressive increase in the incidence of pf. malaria with particular increase during the months of July to October which is being a rainy season. Retrospective data of the number of pf. malaria cases admitted in our hospital in the previous two years also showed increased incidence. CONCLUSIONS Supportive treatment like control of fever, convulsions, blood transfusion is as equally important as specific treatment. Parasite F test is easy to diagnose, even a health worker in PHC can diagnose. Outcome is good when the treatment is started early pointing out to the importance of quick diagnosis and treatment.
Study About Poor Prognosis and Mortality Rate of P.Falciparum Malaria Infection in Children in Bihar
IOSR Journals , 2019
Background: The epidemiology of malaria in children is difficult to assess as most of clinical symptoms are non-specific and most of the cases occur in settings where no routine testing is available. The infection with the species Plasmodium falciparum is one of the leading causes of child death from infectious diseases worldwide. Malaria, a non-fatal disease if detected promptly and treated properly, still causes many deaths in malaria-endemic countries with limited healthcare facilities. Objective: Study about poor prognosis and mortality rate of p.falciparum malaria infection in children in Bihar. Materials & Methods: The study was carried out between Oct 2005 and Sept 2006 in the Department of Paediatrics PMCH Patna. All children (up to 18 yrs of age with fever of short duration visited to hospital either in OPD or indoor without any documented pre-existing systemic illness were included in this study. The cases for present study were selected on random basis amongst the case of malaria as per following protocol. Primary pool patients of all age groups, religion, presented with fever of short duration without any documented pre-existing illness and tested for malaria parasite via PBS (thick & thin smear) and rapid antigen test. Secondary pool cases from primary pool with definite diagnosis of p. falciparum malaria, were further divided into uncomplicated & complicated group according to WHO criteria 2000. Results: About 150 cases were positive for p.falciparum malaria. Out of 150 cases under study 65 (43.33%) were complicated and 85 (56.67%) were uncomplicated cases of p. falciparum malaria. Incidence of p. falciparum malaria among febrile children was 84%. Incidence of p. falciparum was 16% of total malaria cases. Cerebral anemia was commonest complication (29.23%) of p. falciparum infection followed by jaundice (29.2%), hypoglycaemia (29.2%), and severe anemia (24.6%). MODS (21.33%), ARDS (3.07%), shock (3.07%), DIC (1.5%), acidosis (4.61%), ARF (6.15%) were uncommon complications. Number of mortality in complicated malaria was 8 which were 12.3% of complicated malaria and 5.33% of total p.falciparum malaria. Incidence of mortality rate in cerebral malaria was 21.05% which was 50% of total death, in severe anemia 6.25%, in ARF 50%, in shock 50%, pulmonary edema 100% and in MODS 35.71% respectively. Conclusion: Children who were suffering with pulmonary edema, shock, ARF, and cerebral malaria have poor prognosis because mortality rate in the above complications is very high.
International Journal of Advances in Medicine
Background: Malaria is a major health problem in many parts of India and some parts of Andhra Pradesh is one of the endemic areas for malaria. The objective was to study clinical profile and outcome of malaria in both species and mixed infection.Methods: Present study was carried out on 100 patients admitted during the period of November 2016 - October 2018 in Narayana medical college and hospital, Nellore. Malaria confirmed by Peripheral thick and thin smear or Antigen Assay underwent detailed clinical history and physical examination. This was followed by monitoring the outcome of the patients with respect to morbidity and mortality.Results: Out Of the 100 patients 58 patients were from rural background, males were predominant, most common age group was 20-30 (34%) followed by 31-40 (31%). Out of 100 patients, 54 patients were falciparum,44 patients had vivax and two had mixed infection. All of the patients had fever followed by chills and rigors (75%), nausea and vomiting (59%...
Study of Clinical Profile in Malaria at CIMS, Bilaspur, Chhattisgarh, India
IOSR Journal of Dental and Medical Sciences, 2016
Results: A total of 100 cases were included in the study. Mean age was 25.5 years. Amongst them, 62% were male and 38 % were female. The most common form of malaria was in the order of falaparum, vivax and then mixed variety. Max patients 42% presented between 3-7 days after onset of symptoms, most common symptoms were fever (85%) ,followed by vomiting (20%), cough (16%), unconsciousness (16%), seizure (16%), jaundice (13%), breathlessness (11%). No of cases of severe malaria was 38% 15% mortality was noted and 85% had good recovery. Conclusion: The study shows major population were of falciparum malaria. Highest incidence of falciparum malaria is due to patient admitted in tertiary care hospital. Severe malaria is a poor prognostic factor. Combination therapy of artisunate in severe falciparum malaria is good option. Perspective study is needed for studying the changing trends of clinical features of malaria species.
A Clinical Study of Falciparum Malaria - 302 Cases
Medical Journal Armed Forces India, 1998
Three hundred and two cases of falciparum malaria including 30 cases of severe falciparum malaria admitted between Jan 93-Dec 93 were studied for their clinical features and response to treatment. Intermittent or remittent fever with chills and headache were the commonest presentation noted (99.3%). Cough (46.4%), hyperbilirubinemia (31.8%), and pyuria (52.9%) were the other notable features. Anaemia was uncommon (16.6%). Hypoglycaemia was detected in none of the cases. Quinine for 3 days along with tetracycline and sulfadoxine • pyrimethamine achieved a 100 per cent cure rate in uncomplicated chloroquine resistant falciparum malaria. Amodiaquine along with tetracycline and sulfadoxine-pyrimethamine was effective in 76.2 per cent of uncomplicated cases.