Clinical characteristics and fever resolution time in 113 children with malaria from a centre in Karnataka, India

Abstract

The epidemiologic features, clinical presentations and severity of malaria influence effective treatment and control strategies. We aimed to study clinical presentations, complications and fever resolution time (FRT) following chloroquine in childhood malaria. Children hospitalised with fever without any obvious cause in whom rapid diagnostic test confirmed malaria were enrolled for a prospective observational study. Continued fever beyond 96 hours following chloroquine was considered as treatment failure. Of total 113 children with malaria, 76.9% had Plasmodium vivax, 22.1% had Plasmodium falciparum and one had mixed infection. Children from endemic areas constituted 46.1% of cases. Mean duration of fever prior to admission was significantly less among children from endemic than non-endemic areas (p ≤ 0.001). Headache, vomiting, cough and convulsions were present in 42.5%, 31.9%, 20.4% and 1.8% respectively; splenomegaly, hepatomegaly and anemia were observed in 80.5%, 10.6% and 9.7%. Fever resolved in 92.9% with mean FRT of 31.1 ± 17.5 hours. Complications occurred in 11.5%. P. vivax caused malaria usually responded to chloroquine; treatment failure was significantly higher in P. falciparum infections (p < 0.001). The FRT is likely to be of clinical value in resource poor settings.

Keywords

Children - chloroquine - clinical studies - malaria