Prognostie value of fundoscopy in malaria

ABSTRACT

Objective To detect fundoscopic abnormalities in immunocompetent adults with malaria and to assess their prognostic value. Methods A prospective study involved 543 patients with malaria seen during the period Decembre 2000 to July 2001 at the Jordanian Military hospital in Freetown, Sierra Leone. Patients were divided into three groups uncomplicated, severe and cerebral malaria. Diagnosis of malaria was based on peripheral blood smears. All patients were HIV negative. One the day of andmission, fundoscopic examination was performed on all patients through dilated pupils. Results Ninety Seven[17.9%] of all patients were found to have abnormal fundoscopy. Retinal hemorrhage was the most common finding: 8.5% of all patients, 47.4% in respect with abnormal findings. Optic disc pallor was a minority and closely related to cerebral malaria. A significant ratio [57.1%] of uncomplicted malaria cases with abnormal fundoscopy progressed to severe or cerebral malaria within 24 hours. Conclusion Abnormal fundoscopic findings in malaria patients can be early predictor of severe infection