Epidemiological aspects and clinical implications of malaria as seen in Jeddah, Saudi Arabia

A review is presented of 242 patients with acute malaria seen at two hospitals in Jeddah. Jeddah should be regarded as the malaria outpost of the South Western region of Saudi Arabia since nearly all of these patients contracted the disease while travelling within that area during the previous month. Plasmodium falciparum was the predominant infection (77%). There was a marked seasonal incidence with a peak during December to April; 84% of the patients were male. In contrast to the common impression that the total white cell count is low or normal in malaria, one-third of a sample of 124 patients had a total count of at least 10 000 mm-3; approximately 40% of the patients did not have a palpable spleen. Evidence is presented to show the danger of treating patients with falciparum malaria on an out-patient basis. Ideally, all such patients should be hospitalized and observed in order to ensure effective treatment. The Kingdom of Saudi Arabia has many medical and paramedical personnel who have little practical experience in the diagnosis of malaria. We therefore recommend that training programmes in the laboratory diagnosis of malaria should be initiated in specialized centres in the Kingdom or abroad.