Clinical Spectrum of Severe Plasmodium falciparum Malaria in a Tertiary Care Centre of Eastern India

Abstract

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. 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.