Changes in laboratory features of 192 children with imported falciparum malaria treated with quinine

Little is known about changes in laboratory values of children with imported falciparum malaria. Of 192 children, 69% had parasitemia of 2% or less and 64% had platelets <150 x 10/L. In 20%, parasite counts rose within 12-24 hours of starting treatment before falling, whereas the platelet counts dropped in 45% but returned to normal levels within 5 days. Hemoglobin values were <10 g/dL in 31% at presentation and dropped in 61% at 5-21 days after treatment, but did not fall below 6.8 g/dL in any case. Blood cultures were negative in all children. Hyponatremia (n = 16), jaundice (n = 4) and hypoglycemia (n = 0) were uncommon. Thus most children presented with abnormal laboratory values, which initially worsened in a significant proportion, but none required active intervention once therapy was initiated.