Satpathy S K, Mohanty N, Nanda P, Samal G
Department of Pediatrics, M.K.C.G. Medical College and Hospital, Berhampur, Orissa, India.
Indian J Pediatr. 2004 Feb;71(2):133-5. doi: 10.1007/BF02723094.
Falciparum malaria affect all ages with multiple-systemic complications which varies in different age group. We studied 242 children with complicated Falciparum malaria with a median age of 6.5 years to look for occurrence of different complications in younger and older age groups and overall mortality picture. Unarousable coma (40.5%), severe anemia (26.03%), repeated seizures (46.2%) and hepatopathy (32.2%) were commonest complications. Under five children had higher risk of development of cerebral malaria (P<0.01), severe anemia (P<0.05) and seizures (P<0.001); whereas above five children had higher risk of acute renal failure (P<0.05) and malarial hepatopathy (P<0.02). Over all mortality was 9.9%, cerebral malaria being the commonest cause (6.6%). Multi-system involvement was seen in 58.4% cases of death. Children having pulmonary edema, shock and cerebral malaria had high case fatality rate.
恶性疟影响所有年龄段,会引发多种全身并发症,不同年龄组的并发症有所不同。我们研究了242例患有复杂恶性疟的儿童,中位年龄为6.5岁,以观察不同年龄组中不同并发症的发生情况以及总体死亡率情况。不可唤醒的昏迷(40.5%)、严重贫血(26.03%)、反复惊厥(46.2%)和肝病(32.2%)是最常见的并发症。5岁以下儿童发生脑型疟(P<0.01)、严重贫血(P<0.05)和惊厥(P<0.001)的风险更高;而5岁以上儿童发生急性肾衰竭(P<0.05)和疟疾性肝病(P<0.02)的风险更高。总体死亡率为9.9%,脑型疟是最常见的死因(6.6%)。58.4%的死亡病例存在多系统受累情况。患有肺水肿、休克和脑型疟的儿童病死率很高。