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Epidemiology of cerebral malaria and its mortality
A B Durrani1, I U Durrani, N Abbas
1Department of Medicine, Bolan Medical College, Quetta.
Abstract:
Over the past 5 years, 1620 comatosed patients of both sexes aged 1-75 years were screened for cerebral malaria. Of these, 505 (31.2%) were positive for Plasmodium falciparum. During this period frequency of malaria increased from 22.1% in 1991 to 44.4% in 1995. Sixty-four percent cases of cerebral malaria were seen in children and thirty-six percent in adults. Mortality was also higher (41%) in children than in adults (25%). As cerebral malaria is particularly prevalent in Pakistan and is a major community problem, accurate and easier methods of its diagnosis are needed at primary health care level, in all febrile comatose patients, without focal neurological findings.
Insights
Cerebral malaria, caused by Plasmodium falciparum, significantly increased in Pakistan, particularly affecting children. Early diagnosis in febrile, comatose patients is crucial for better outcomes.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Neurology
Background:
- Cerebral malaria is a severe manifestation of Plasmodium falciparum infection.
- Pakistan faces a significant burden of cerebral malaria, posing a major community health challenge.
- The prevalence of malaria has notably increased in recent years.
Purpose of the Study:
- To determine the prevalence of Plasmodium falciparum in comatose patients.
- To analyze the demographic distribution and mortality rates of cerebral malaria.
- To highlight the need for improved diagnostic methods at the primary healthcare level.
Main Methods:
- Screening of 1620 comatose patients (aged 1-75 years) over a 5-year period.
- Diagnosis of Plasmodium falciparum using parasitological methods.
- Analysis of malaria frequency trends and patient demographics.
Main Results:
- 505 patients (31.2%) tested positive for Plasmodium falciparum.
- Malaria frequency rose from 22.1% in 1991 to 44.4% in 1995.
- Cerebral malaria was more common in children (64%) than adults (36%), with higher mortality in children (41% vs. 25%).
Conclusions:
- Cerebral malaria is a significant health issue in Pakistan, with a concerning rise in cases.
- Children are disproportionately affected by cerebral malaria, experiencing higher mortality rates.
- There is an urgent need for accessible and accurate diagnostic tools for cerebral malaria at the primary healthcare level for febrile comatose patients without focal neurological findings.