Abstract

Severe and complicated malaria is defined by the World Health Organization Malaria Action Programme in June 19851 as the presence of one or more of the following conditions in a slide confirmed diagnosed case of malaria cerebral malaria, severe anemia, renal failure, pulmonary edema or adult respiratory distress syndrome, hypoglycemia, circulatory collapse or shock, spontaneous bleeding, repeated generalized convulsions, acidemia or acidosis, macroscopic hemoglobinuria, impairment of consciousness less marked than unarousable coma,, hyperparasitemia, jaundice, hyperpyrexia, and the presence of complicating or associated infections. However, severe anemia and thrombocytopenia that causes bleeding diatesis is produced by hemolysis, reduced cell deformity of parasitized and non-parasitized erythrocytes, increased splenic clearance, reduction of platelet survival, decreased platelet production, and increased splenic uptake of platelets. Though these changes can be produced by P. vivax and P. falciparum infection yet the complicated malaria has commonly been associated with P. falciparum infections.

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