Falciparum malaria-an experience with 100 cases

ABSTRACT

Clinical details and present day problems faced in 100 cases of Falciparum Malaria [FM] are reported. Eleven percent had taken chloroquine prior to reporting to us. The parasite density lacked correlation with the severity of disease. Pattern of fever varied markedly but 10% were afebrile throughout and presented only with body ache and malaise. Cerebral malaria was present in 11% patients. Jaundice was present in 18% patients. Other symptoms were vomiting 44%, severe headache 12%, pain abdomen 7%, loose motions/dysentery 11%, and cough 8%, while bleeding diathesis was present in 7% [3 melena, 2 epistaxis, 1 bleeding gums and 1 haematuria]. Severe anaemia was present in 10% of cases. Splenomegaly was present in 65%, hepatomegaly 29% and hepatosplenomegaly 21%. Congenital malaria was present in only one [1%] patient. Mild malaria patients were treated with chloroquine, while severe malaria patients were cured with quinine for 7 days. Blackwater fever was present in 2%. Patients with blackwater fever were cured with steroids and chloroquine. 12% patients had chronic malaria. 83% of these patients presented with anaemia. Self medication, haphazard therapy and the slogan "Fever May Be Malaria, Take Chloroquine" can lead to problems in Falciparum Malaria. Clinical immunity and parasite strain may act as virulence factors