Falciparum malaria in a South African Tertiary Care Hospital

Abstract

This study was a retrospective case series over one year. The purpose was to review the clinical presentation, travel history, laboratory findings and outcome of Plasmodium falciparum malaria. The study was conducted in the medical wards of Dr. George Mukhari Hospital, a teaching hospital in South Africa that serves mainly black patients. Fifty-nine patients were evaluated. The mean age was 34 years. Twenty-three patients (39%) had strictly defined severe malaria. Ninety-eight percent acquired Plasmodium falciparum in Sub-Saharan Africa. The death rate was 1.7%. Virtually all patients had a travel history obtained in the emergency department and the diagnosis was confirmed in all cases within 24 hours of admission. In our study population, the differences in the percent parasitemia, platelet count, haemoglobin and bilirubin were not statistically significant between the cases with severe and those with less severe malaria. Plasmodium falciparum malaria should not carry a high mortality in adequately equipped centers, when the diagnosis is made early and therapy is instituted promptly.