Severe P. falciparum malaria in children in a tertiary care center of Allahabad region of india.

Background & objectives: Despite a substantial disease burden in this area, little is known about the natural history of complicated falciparum malaria. Therefore, the present prospective study was undertaken to assess the clinical course, complications and outcome i.e. to understand the pattern of morbidity and mortality of falciparum malaria in children in tertiary care center of Allahabad.Methods: This was a prospective hospital based study conducted on 150 consecutive pediatric admissions under the age group of 1-5 years of slide positive complicated falciparum malaria cases between May 2005 to June 2007. The cases were retrieved and scrutinised using a prepared case sheet performa on the basis of patient’s detailed history, clinical findings, investigations, treatment and complications.Results: 150 children with complicated Falciparum malaria with a mean age of 4.9±4.08 years to look for occurrence of different complications in younger and older age groups and overall mortality picture. Prostration (49.3%), Severe anemia (48.6%), unarousable coma (27.3%), and Respiratory distress(24.0%) were commonest complications. Under five children had higher risk of development of severe anemia (P<0.05) cerebral malaria (P<0.05), respiratory distress (<0.05) and seizures (P<0.05); whereas above five children had higher risk of prostration (P<0.05), jaundice (P<0.05) and acute renal failure (P<0.05). Over all mortality was 13.7%, cerebral malaria being the commonest cause (14.6%). Conclusion : Malaria is responsible for major health concern in this region especially in rural areas, particularly in rainy season and is found to affect comparatively the younger children population. High degree suspicion should be maintained to detect these complications in early stage so that malarial mortality and morbidity can be prevented.