Cerebral Malaria in Phaholpholphayuhasena Hospital 1988-1991

Abstract

Between October 1988 and September 1991, 74 patients diagnosed as having cerebral malaria according to WHO 1991 's criteria were admitted to Phaholpholphayuhasena Provincial Hospital, which was accounted for 2.02% of falciparum malaria patients admitted in the same period.

The incidence was high during rainy season. One fourth of cerebral malaria patients developed convulsions prior to admission and up to 50% of the causes received antimalarial treatment before admission. Treatment using loading of Quinine did not reduce the mortality rate (p > 0.05). Complications included anemia (48.6%), jaundice (62.1%), hypoglycemia (50%), and acute renal failure (40.1%) were found in these patients. The mortality rate in patients who developed renal failure with no urine was high (66.7%) when compared to the overall mortality rate (44.6%). The two major causes of dead were acute renal failure and pulmonary edema which were responsible for over half of the mortality (57.6%). Physician should be alert for these two complications, prevention, early detection and early treatment of these two complications were highly recommended.