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Severe falciparum malaria
S K Satpathy1, N Mohanty, P Nanda
1Department of Pediatrics, M.K.C.G. Medical College and Hospital, Berhampur, Orissa, India. sarojsat@yahoo.co.uk
Indian Journal of Pediatrics
|April 1, 2004
Summary
Complicated childhood malaria presents varied risks by age. Younger children face higher risks of cerebral malaria, anemia, and seizures, while older children are more prone to acute renal failure and hepatopathy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Tropical Medicine
Background:
- Falciparum malaria causes severe, multi-systemic complications affecting all age groups.
- Complication patterns and mortality risks differ across pediatric age demographics.
Purpose of the Study:
- To investigate age-specific complications of complicated Falciparum malaria in children.
- To analyze the overall mortality and risk factors in pediatric malaria cases.
Main Methods:
- Retrospective study of 242 children diagnosed with complicated Falciparum malaria.
- Analysis of complication occurrence and mortality rates stratified by age groups (under five vs. over five years).
Main Results:
- Common complications included unarousable coma (40.5%), severe anemia (26.03%), seizures (46.2%), and hepatopathy (32.2%).
- Children under five had increased risks for cerebral malaria, severe anemia, and seizures (P<0.01, P<0.05, P<0.001 respectively).
- Children over five showed higher risks for acute renal failure and malarial hepatopathy (P<0.05, P<0.02 respectively). Overall mortality was 9.9%, with cerebral malaria being the leading cause (6.6%).
Conclusions:
- Age significantly influences the presentation and severity of Falciparum malaria complications in children.
- Cerebral malaria, shock, and pulmonary edema are associated with high fatality rates.
- Multi-system involvement is prevalent in fatal pediatric malaria cases, underscoring the need for comprehensive management.