Treatment outcome of severe malaria in adults with emphasis on neurological manifestations at Gondar University Hospital, north west Ethiopia

Abstract

Background: Malaria is a major health threat in Ethiopia. Unstable malaria transmissions cause severe clinical manifestations and result in high case fatality.

Objective: The aim of this study was to asses the clinical features and treatment outcome of severe malaria cases with special emphasis on the neurologic manifestations.
Methods: A retrospective medical records analysis was done at Gondar University hospital, which is located in Gondar town. br> Results: Severe malaria accounted for 4.4% of the admissions and for 7.3% of the deaths occurring in the medical wards of the hospital. Neurological manifestations were observed in 61.5% of cases. The crude case fatality rate was 28.4% with 87.1% of the deaths having neurologic manifestations. Cerebral malaria accounted for 58.1% of the deaths and it was the most significant independent variable predicting poor outcome. Other poor prognostic indicators were late presentation to the hospital, acidotic breathing, pulmonary edema, shock or/hypotension, hyperparasitemia, rural residence and age 40 years and above in adults.
Conclusion and recommendations: Neurological manifestations were the major determinant of morbidity and mortality in severe malaria cases in adults. This study indicates that more emphasis needs to be given to prevention and early management of malaria. Priority should also be given to patients with neurologic manifestations and they should be cared for in intensive care units.

The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 106-111