Abstract
BackgroundMortality of falciparum malaria is related to the presence of severe complications. However, no scoring system is available to predict outcome of these patients. The aim of this paper was to devise a simple and reliable malaria prognosis score (MPS) to predict the outcome of adults with severe malaria.MethodsAll slide-positive severe falciparum malaria patients admitted to Ispat General Hospital were studied. Eight clinical parameters that may potentially differentiate or influence the outcome were identified to predict recovery or deathResultsOf 248 severe malaria cases, 35 died. There were 212 adults (34 deaths) and 36 children (one death). The malaria score for adults was (MSA) = 1(severe anaemia) + 2 (acute renal failure) + 3(Respiratory distress) +4 (cerebral malaria). The MSA ranges from 0 to 10. The mortality was 2% for MSA 0 – 2; 10% for MSA 3–4, 40% for MSA 5–6 and 90% for MSA 7 or more. The sensitivity is 89.9% and positive predictive value is 94.1% when 5 is taken as the cut off value.ConclusionMSA is a simple and sensitive predictor. It can be administered rapidly and repeatedly to prognosticate the outcome of severe malaria in adults. It can help the treating doctor to assess the patient as well as to communicate to the relatives of the patients about prognosis. The score needs revalidation in other geographical areas.
Highlights
Mortality of falciparum malaria is related to the presence of severe complications
Severe falciparum malariais associated with various complications
Being a large and well-equipped hospital, over the years it has established as a tertiary care center for seriously ill patients from the adjoining districts of Orissa, Jharkhand, Chhatisgarh, Madhya Pradesh and Bihar. Patients This hospital-based study was conducted on patients over 12 years of age presenting with falciparum malaria who met the WHO criteria of severe and complicated falciparum malaria [1]
Summary
Mortality of falciparum malaria is related to the presence of severe complications. No scoring system is available to predict outcome of these patients. The aim of this paper was to devise a simple and reliable malaria prognosis score (MPS) to predict the outcome of adults with severe malaria. Falciparum malaria is a leading cause of mortality and morbidity in developing countries [1]. Severe falciparum malariais associated with various complications. It is well known that the presence of multiple complications results in increased mortality. Molyneux et al described the clinical and prognostic indicators of cerebral malaria in children [5]. No prediction scoring system is yet available to prognosticate the outcome in severe malaria among adult patients
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