Clinical profile and prognostic factors of severe falciparum malaria in a tertiary care hospital.

Sir, W read the article of Dr.Wasnik, Dr Manohar e t a l regarding ‘Clinical profile of falciparum malaria’ (JAPI,October2010;60:33-36),with great interest. In their study of 80 patients 37 had severe malaria and 43 had uncomplicated malaria.1 We hereby submit a study report of 50 cases of severe P. Falciparum Malaria, admitted in medicine ward a t g o v e r n m e n t m e d i c a l c o l l e g e , Aurangabad, from a period of November 2009 to November 2011. Malaria was diagnosed on the basis of peripheral smear and rapid Malarial test. Cases satisfying WHO criteria of severe Malaria (i.e. Cerebral Malaria / coma, Acidosis, severe Anaemia, Renal fai lure, Pulmonary oedema/ ARDS, hypoglycaemia, hypotension / shock, bleeding / DIC, Convulsions, h a e m o g l o b i n u r i a , i m p a i r e d consciousness, hyperparasitaemia, Jaundice) were included in the study. In this Hospital based cross sectional study, out of 50 patients 39 (78%) patients recovered completely, 11(22%) patients died. Mean age of patients was 39.92 years, male:female ratio was 1.08:1. Mean BMI was 22.26. Most common manifestation in our study was jaundice (78%) followed by bleeding tendencies (60%). Platelet count < 50,000 /μl was found in 30(60%) patients. Prothrombin time > 18 sec was found in 8(16%) patients. 26(52%) patients received inj Artesunate in combination with Sulphadoxine-pyrimethamine/ doxycycl ine and 24(48%) pat ients Table 1 : Outcome of various manifestation of severe P. Falciparum Malaria in study group