Clinical and epidemiological study of patients with malaria treated at the hospital central de Las Fuerzas Armadas in Dominican Republic

Abstract

Background: As a tropical country, Dominican Republic is a malaria endemic area and although it has reduced its incidence, continues to be in the differential diagnosis of febrile illnesses. Methods: This is a retrospective study to assess the epidemiological and clinical characteristics of patients diagnosed with Malaria admitted from January 2008 to November 2009, at the hospital, a tertiary-care center, and regional reference, that serves to the military population, relatives of these and the civilian population as social action. Inclusion criteria were suspected diagnosis of Malaria at the time of admission and confirmed by the presence of asexual forms in thin blood smears or thick made at the time of initial evaluation. Results: Of 93 febrile patients admitted with suspected malaria, this diagnosis was confirmed in 13 (13.9%), 11 (84.6%) were men. The mean age found was 32 Years (range 15-62). While 46.1% were found within Santo Domingo and Distrito Nacional, the distribution by region was: South (7.7%), North (7.7%), the border region (38.5%). All were symptomatic at diagnosis. The typical clinical presentation observed in most cases: fever (98.4%), headache (85.6%), chills (46.6%), myalgia (34.5%) and jaundice (10.9%). All were managed within the hospital, required standard of this military institution. All cases were autochthonous and P. falciparum were the only parasite found in all the patients, responding satisfactory to chloroquine and primaquine treatment. Death occurred in 1 (7.7%). The average time between the start of clinical setting and the diagnosis was 6.5 days for patients who were transfer from other parts of the country and 2.8 days (p < 0.05) for those who came seeking medical care directly in the hospital. Conclusion: Attention should be given to febrile patients, and test to investigate malaria must be included as a routine, regardless of the provenance, but especially those living in the border region with Haiti, the interval between the clinical setting and the diagnosis has a prognosis value. The P. falciparum is the unique species prevalent in Dominican Republic, and chloroquine and primaquine continues to be therapeutic option of choice. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive