Clinical profile and characteristics of cerebral malaria: An observational study in a tertiary care hospital in Western Maharashtra

Abstract

Background: Cerebral malaria is a serious and potentially fatal complication of malaria caused by Plasmodium falciparum parasites. Symptoms may include an unarousable coma lasting for at least 30 min, seizures, altered sensorium, and fever. Diagnosis is made through a combination of clinical and laboratory findings, including the identification of parasites in blood smears or rapid diagnostic tests. Treatment involves prompt use of antimalarial drugs and supportive care. Severe cases of malaria can lead to complications such as cerebral malaria, severe anemia, and organ failure. Aim and Objective: The aim of thje study was to understand clinical profile and characteristics of cerebral malaria. Materials and Methods: This observational study conducted at a tertiary care center from September 2016 to June 2018. The study included patients aged 18 years and above who were admitted to the center and exhibited symptoms of altered sensorium, coma, convulsion, and fever with altered sensorium. Patients who tested positive for malarial parasites on peripheral smear or rapid malaria antigen were also included in the study. The study was ethically approved by the institutional committee and all participants provided informed consent before enrollment. The sample size included 30 patients. Results: The study involved 30 hospitalized patients with severe falciparum malaria. Of the patients, 60% were male and 40% were female, with a male to female ratio of 3:2. The average age was 42.3 years, with the highest number of patients belonging to the age group of 18–30 years. All patients had fever, with the majority reporting altered sensorium, chills and rigors, headache, and nausea. Multiorgan dysfunction was more common than extracranial single system involvement. CSF analysis showed normal cytology, with normal or slightly elevated protein and sugar levels. Most patients had a Glasgow coma scale score between 11 and 15, with brain edema and retinal changes observed in some patients. Conclusion: The study concludes that hospitalized patients with severe falciparum malaria, predominantly affecting young adults. Symptoms included fever, altered sensorium, chills, and rigors, with multiorgan dysfunction being more common than single-system involvement.