Clinical profile and outcome of cerebral malaria in pediatric cases at a tertiary Care Hospital

Abstract

Background: Cerebral malaria (CM) is a potentially fatal condition encountered in all age groups and if not treated timely can cause mortality. Objective: to evaluate the clinical features of cerebral malaria in children at a tertiary care Hospital of Telangana. Methods: This was a prospective study carried out from January 2013 to December 2014 at a tertiary care hospital of Telangana. Clinical profile, treatment and outcome of all the children diagnosed with CM aged between 5 months to 12 years were assessed. Results: There were a total of 65 patients with CM of which 40 (74.7%) of them were girls and 20 were boys (25%). P. falciparum was the main infecting species in both uncomplicated malaria and severe malaria cases. The clinical features noted were seizure (39.62%), anemia (84.9%), icterus (16.98%), hypotension (13.2%), bleeding (3.7%), hepatomegaly (5.66%), splenomegaly (5.66%), pulmonary edema (16.98%) and renal dysfunction (37.36%). Treatment received included artesunin compounds or quinine. Complete recovery was achieved in 53 (81%) of them. Three (6.1%) of them died. Conclusion: CM considered being a fatal disease has shown remarkable improvement in the outcome with the wide availability of artesunin and quinine components. The key to management is early diagnosis and initiation of treatment based on a high index of suspicion.