Clinical presentation of severe malaria due plasmodiun falciparum. Casecontrol study in Tumaco and Turbo (Colombia).

Abstract

BACKGROUND: Latin American studies on severe falciparum malaria are scarce, therefore, the pattern of complications of the region is uknown.

OBJECTIVES. To identify characterize severe malaria in patients from Tumaco (Nariño) and Turbo (Antioquia) in Colombia.

METHODS. The 2000 World Health Organization criteria for complicated malaria were applied in a cases and controls study.

RESULTS. 64 cases (P falciparum complicated malaria) and 135 controls (P falciparum uncomplicated malaria) were included. The time of evolution of the disease (mean 5.6 days in cases and 5.9 in the controls) and the frequency of most symptoms were similar in both groups (p>0.05). However, respiratory distress and jaundice was more frequent in the cases (p<0.05). The mean glycemia and creatinina values were similar in both groups; hemoglobin and platelet count were lower in the cases (p<0.05) when compared to controls. On the other hand, blood ureic nitrogen, aspartatoaminotransferase, and total and direct bilirrubin were lower in controls (p<0.05). The frequency of complications in the cases was as follows: hyperparasitaemia 48%, liver dysfunction 44%, acute respiratory distress syndrome 9%, kidney failure 6%, severe thrombocytopenia 5%, severe anemia 3%, cerebral malaria 3% and severe hipoglycemia 2%. The WHO criteria for severe malaria were compared with others and the implications are discussed.