Title

Comparative features and outcomes of malaria at a tertiary care hospital in Karachi, Pakistan

Document Type

Article

Department

Pathology and Microbiology

Abstract

Objectives:

A comparison of clinical and laboratory features, diagnostic methods, drug treatment, and outcomes for Patients hospitalized with malaria by Plasmodium species.

Methods:

Records of 521 Patients hospitalized during the four and half-year study period were analyzed.

Results:

Infections were caused by Plasmodium vivax (51.8%), Plosmodium falciporum (46.5%), P vivax plus P falciparum (1.3%), and Plasmodium malariae (0.4%). Vomiting (odds ratio (OR) = 1.86, p = 0.001) and abdominal pain (OR = 1.60, p = 0.024) occurred more frequently inPatients infected with P falciparum compared to P vivax, this was also the case for hepatomegaly, splenomegaly and jaundice. Low hemoglobin levels were common but were significantly tower with P falciparum, and creatinine levels were significantly higher with P falciparum. Treatment regimens consisted of single drug therapy (61.5%), appropriate combination therapy (15.8%), and inappropriate combination therapy (22.7%). Antimalarials given alone included chloroquine (38.7%), quinine (19%) and doxycycline (1.5%). The overall mortality was 1.7% (n = 9) and nearly 56% of Patients developed disease complications, most commonly thrombocytopenia (36.4%), anemia (23.4%), and thrombocytopenia plus anemia (32.7%).

Conclusion:

Despite resistance, chloroquine was prescribed in Patients with malaria requiring hospitalization. We found a high proportion of single antimalarial drug use as well as inappropriate combination therapy (22.7%), and inadequate use of primaquine terminal prophylaxis. Physicians need to be acquainted with malaria treatment guidelines in an endemic zone.

Publication

International Journal of Infectious Diseases