Mortality Of Falciparum Malaria Research Articles

Information Education and Communication can Improve Adherence to Artemether-Lumefantrine Combination in Patients of Uncomplicated Falciparum Malaria.

Early diagnosis and prompt treatment with Artemisinin combination therapy (ACT) is vital to improve mortality in Falciparum Malaria. Information education and communication (IEC) is a strong tool that can improve drug adherence. To explore if IEC in the form of designed drug bags with verbal communication can improve ACT adherence in Falciparum Malaria patients. A prospective, interventional, controlled study was conducted in OPD patients of both SCB Medical college, Cuttack and district headquarter hospital Cuttack district of Odisha. IEC material in the form of well designed drug bag and verbal communication was used for intervention. Control group received ACT combinations but were not given IEC. Adherence to IEC was significantly higher (81%) in patients receiving IEC compared to controlled patients not receiving IEC. Educational status and the geographical area of the patient were found out to affect adherence to IEC to a significant extent. IEC in the form of designed drug bags, supplemented by verbal communication can improve ACT adherence in Falciparum Malaria.

Severity in Plasmodium vivax malaria claiming global vigilance and exploration--a tertiary care centre-based cohort study.

BackgroundMounting reports on severe Plasmodium vivax malaria from across the globe have raised concerns among the scientific community. However, the risk of P. vivax resulting in complicated malaria and mortality is not as firmly established as it is with Plasmodium falciparum. This study was conducted to determine the severity proportion and factors associated with severity in cases of vivax and falciparum malaria.MethodsAdult patients microscopically diagnosed to have P. vivax/P. falciparum infections from the year 2007-2011 were evaluated based on their hospital records. Severe malaria was defined as per the World Health Organization’s guidelines. Comparison was made across species and binary logistic regression was used to determine risk factors of severity.ResultsOf 922 malaria cases included in the study, P. vivax was the largest (63.4%, 95% confidence interval (CI) 60.3-66.5%) infecting species, followed by P. falciparum (34.4%, 95% CI 31.3-37.5%) and their mixed infection (2.2%, 95% CI 1.3-3.2%). Severity in P. vivax and P. falciparum was noted to be 16.9% (95% CI 13.9-19.9%) and 36.3% (95% CI 31.0-41.6%) respectively. Plasmodium falciparum had significantly higher odds [adjusted odds ratio (95% CI), 2.80 (2.04-3.83)] of severe malaria than P. vivax. Rising respiratory rate [1.29 (1.15-1.46)], falling systolic blood pressure [0.96 (0.93-0.99)], leucocytosis [12.87 (1.43-115.93)] and haematuria [59.36 (13.51-260.81)] were the independent predictors of severity in P. vivax. Increasing parasite index [2.97 (1.11-7.98)] alone was the independent predictor of severity in P. falciparum. Mortality in vivax and falciparum malaria was 0.34% (95% CI -0.13-0.81%) and 2.21% (95% CI 0.59-3.83%), respectively. Except hyperparasitaemia and shock, other complications were associated (P < 0.05) with mortality in falciparum malaria. Pulmonary oedema/acute respiratory distress syndrome was associated (P = 0.003) with mortality in vivax malaria. Retrospective design of this study possesses inherent limitations.ConclusionsPlasmodium vivax does cause severe malaria and mortality in substantial proportion but results in much lesser amalgamations of multi-organ involvements than P. falciparum. Pulmonary oedema/acute respiratory distress syndrome in P. vivax infection could lead to mortality and therefore should be diagnosed and treated promptly. Mounting complications and its broadening spectrum in ‘not so benign’ P. vivax warrants global vigilance for any probable impositions.Electronic supplementary materialThe online version of this article (doi:10.1186/1475-2875-13-304) contains supplementary material, which is available to authorized users.

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.