Observational Study of Complications of Plasmodium falciparum in Central Rural India

Abstract

Aims and Objectives: The present study aims to understand the clinical course of the disease, complications, their response to treatment and outcomes in patients with Plasmodium falciparum malaria infection. Method: Total 201 patients of age more than 12 year were recruited for the study. Rapid diagnostic test or peripheral smears positive for falciparum malaria were considered diagnostic. Out of total cases 99 were falciparum positive. Detailed history, physical and clinical examination and required investigations were done in all cases. Patient had been started on standard treatment of malaria and reviewed for any complication developed. Course of the disease in hospital and response to the antimalarial had been noted. Results: Majority of our cases were males of more than twelve years. Fever was most common presenting symptom in 98% of patients. Thrombocytopenia was the commonest complication of malaria followed by cerebral malaria, jaundice, acute renal failure, anaemia, algid malaria, metabolic acidosis, respiratory distress and hypoglycaemia. Total 91 (91.92%) patients were treated with ACT but 8 (8.08%) patients have resistant to ACT and they were treated with Arthemeter plus lumifantrine. The most common cause of death was found to be cerebral malaria which was observed in 100 % of death. Other causes were algid malaria, severe thrombocytopenia, metabolic acidosis, jaundice, acute renal failure and respiratory distress. Conclusion: Early diagnosis, early recognition of risk factors and complications, prompt treatment form the backbone of malaria management to reduce the morbidity and associated mortality.