Malaria due to Plasmodium vivax or P. falciparum in a tertiary hospital in the most endemic region of Colombia

Abstract

Problem: in Colombia there are few reports on severe malaria, especially produced under well supported protocols.

Objective: to describe the clinical characteristics of patients at the Hospital San Jeronimo (HSJ) of Montería, 2009-2010, and identify and quantify the severe clinical syndromes.

Methodology: a descriptive, retrospective, cross-sectional study of all patients hospitalized with a diagnosis of malaria.

Results: there were 126 patients with malaria in the HSJ; 74% were referred from surrounding municipalities; Plasmodium vivax caused 60% of cases; 54% were women (29 of 68 were pregnant women, namely with gestational malaria); patients were young (23.3 ± 19.3 years); the average evolution of its current malaria was 4-5 days; the average parasitemia when entering the HSJ was 13 628 ± 26 790 parasites / microliter. The classic triad of fever, chills and headache were found in at least two out of three patients on admission. The average hemoglobin indicates moderate anemia The 126 patients provided 194 adverse events and complications. The most frequent complications were (percentage of 126 patients): thrombocytopenia 76%; anemia (<7 g/dL hemoglobin) 17%; renal failure 10%; liver failure 10%; cerebral complication (fever + seizures without coma: 7 cases, fever + convulsions + coma: 1 case) 6%; five cases were due to P. vivax, 2 to P. falciparum and 1 to both species (mixed); failure of 2-3 systems 11%.

Conclusions: the development of studies on severe malaria is required in Colombia to comprehensively assess patients with well-defined protocols and diagnostic criteria which compare diagnostic criteria of severity and treatment guidelines to develop an indigenous rule on the matter