CLINICAL AND LABORATORY CORRELATES OF THE OUTCOME OF CEREBRAL MALARIA IN THE PHILIPPINES

P. Tongol-Rivera, M. Prudencio, J. Sarol, Felipe Balingit, Elena A. Villacorte, Aldrin Darilag, Mamoru Suzuki, S. Kano
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Abstract

This study describes the socio-demographic profile of cerebral malaria (CM) patients and identifies the clinical and laboratory factors which correlate with mortality from this condition. Records of 97 CM cases admitted at the Davao Regional Hospital, Philippines from 1990 to 1995 were reviewed. Information on socio-demographic factors, clinical signs and symptoms, physical examination and laboratory findings and medicines given during hospitalization were obtained. Associations of these variables with mortality were examined by generating two-way tables for qualitative variables and computing descriptive statistics for quantitative variables. Results showed that CM was more common among males and young adults who comprise the economically productive age group (21-40 years) and who are engaged in slash and burn agriculture. Using bivariate analysis, factors that correlated with mortality included age, residence, back/abdominal pain, fever, coma, dyspnea, diastolic blood pressure (BP), white blood cell (WBC), neutrophil and lymphocyte counts, trophozoite count and quinine infusion. Logistic regression analysis showed that only back/abdominal pain, coma, dyspnea, diastolic BP and trophozoite count remained statistically significant after simultaneously controlling for confounding. These results can contribute to the proper assessment and improvement in the clinical management of CM.
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菲律宾脑型疟疾结果的临床和实验室相关因素
本研究描述了脑疟疾(CM)患者的社会人口特征,并确定了与该病死亡率相关的临床和实验室因素。审查了1990年至1995年在菲律宾达沃地区医院收治的97例慢性脊髓炎病例的记录。获得了有关社会人口因素、临床体征和症状、体格检查和实验室结果以及住院期间服用药物的信息。通过生成定性变量的双向表和计算定量变量的描述性统计来检查这些变量与死亡率的关联。结果表明,CM在经济生产年龄组(21-40岁)从事刀耕火种农业的男性和青壮年中更为常见。通过双变量分析,与死亡率相关的因素包括年龄、居住地、背部/腹部疼痛、发热、昏迷、呼吸困难、舒张压(BP)、白细胞(WBC)、中性粒细胞和淋巴细胞计数、滋养体计数和奎宁输注。Logistic回归分析显示,在同时控制混杂因素后,只有腰/腹痛、昏迷、呼吸困难、舒张压和滋养体计数具有统计学意义。这些结果有助于正确评估和改进CM的临床管理。
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