Study of features associated with death in children with severe malaria at a tertiary care hospital in Western India
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2017, Vol 4, Issue 9
Abstract
Background: India contributes significantly to world malaria load and it accounts for 6% of the total malaria cases, 49 % of the vivax malaria cases and 51% of vivax malaria deaths across the world. There is scarce information about predictors of mortality in children with severe malaria from India. Objectives: To study the factors associated with death in children with severe malaria at a tertiary care hospital in western India. Methods: A retrospective study was conducted at the pediatric department of a tertiary care hospital(Mumbai) over a three-year period.Demographic data, clinical and laboratory findings of patients with slide-positive malaria were collected from hospital records. Children with any one of the manifestations of severe malariaas per WHO protocol were enrolled in the study.Univariate and multiple regression analysis were usedto identify major predictors of death like: 1) Severe Anemia, 2) Respiratory distress, 3) Multiple generalized convulsions, 4) Spontaneous bleeding, 5) Hemoglobinuria, 6) Impaired consciousness, 7) Jaundice, 8) Prostration, 9) Circulatory Collapse, 10) Pulmonary oedema. Results: Sixty-four subjectswere enrolled in the study. The case fatality rate was 20%. Thirty five (55%) patients presented with more than one predictor.The mortality rate was consistently high in patients having more than one predictor. Univariate analysis identified spontaneous bleeding (35% mortality)and multiple convulsions (60 % mortality) as major predictors of death. Multivariate analysis showed no single factor emerged as a significant predictor of death. Conclusions: Spontaneous bleeding and multiple convulsions emerged as significant predictors of death during Univariate analysis. However no single factor emerged as significant predictor during multivariate analysis.
Authors and Affiliations
Anjali Bharani
Keywords
Related Articles
- EP ID EP285891
- DOI 10.17511/ijpr.2017.09.04
- Views 155
- Downloads 0
Clinicohematological profile of hemolytic anaemia in tertiary care hospital in rural Andhra Pradesh
Introduction: Hemolytic anaemias are a group of disorders that cause significant morbidity in children. Method: A cross sectional study was conducted at NRI Medical College for a period of 1 year. All cases of newly diag...
Correlation between actual and pH corrected ionic calcium in criticallyill pediatric patients
Introduction: Many authors have tried to prove a causal relationship between hypocalcemia and increased mortality in ICUs. For many years correction of ionic calcium for albumin level and magnesium levels has been done....
Analysis of the maternal factors associated with VLBW babies
Introduction: VLBW is associated with increased mortality and morbidity. In country like India where poverty, illiteracy & low socio-economic factors play a major role, incidence of VLBW & its complications can be reduce...
A study of effect of gestational diabetes on the newborn
Introduction: Gestational diabetes mellitus has become the nightmare of the modern mothers due to its varied ill effects on the baby. As many of the ill effects can be well taken care with proper education, anticipation...
Coagulation Profile in Perinatal Asphyxia
Introduction: Perinatal asphyxia is a common problem with devastating consequences in neonatal practice. Bleeding due to coagulation abnormality is very common and is potentially treatable. Various mechanisms including l...