Wattanagoon Y, Srivilairit S, Looareesuwan S, White N J
Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Trans R Soc Trop Med Hyg. 1994 Jul-Aug;88(4):426-8. doi: 10.1016/0035-9203(94)90415-4.
A retrospective survey was conducted of all 2911 children admitted with malaria to 4 provincial hospitals in eastern Thailand between 1977 and 1987. 96 (3.3%) had cerebral malaria of whom 21 (22%) died, 225 (7.7%) had convulsions but were not comatose (4 died), and 2590 were conscious and had no fits (5 died). Thus the relative risk of a fatal outcome associated with convulsions, in the absence of cerebral malaria, was 9.2 (95% confidence interval [CI] = 2.5-34.1), P = 0.004. Overall, Plasmodium falciparum caused 81% of infections, P. vivax 16%, and 3% were mixed. Convulsions without cerebral malaria were more common in children under 3 years old (16%) compared with older children (3%): relative risk 5.6 (95% CI = 4.2-7.5), and were significantly associated with falciparum malaria (8.3%) compared with vivax malaria (4.7%): relative risk 1.7 (95% CI = 1.1-2.7). Convulsions are an important complication of malaria in young children, and are associated specifically with P. falciparum infection, even in otherwise uncomplicated malaria.
对1977年至1987年间泰国东部4家省级医院收治的2911例疟疾患儿进行了回顾性调查。96例（3.3%）患有脑型疟疾，其中21例（22%）死亡；225例（7.7%）有惊厥但未昏迷（4例死亡）；2590例意识清醒且无抽搐（5例死亡）。因此，在无脑型疟疾的情况下，惊厥相关的致命结局相对风险为9.2（95%置信区间[CI]=2.5 - 34.1），P = 0.004。总体而言，恶性疟原虫引起81%的感染，间日疟原虫引起16%，3%为混合感染。无脑型疟疾的惊厥在3岁以下儿童中（16%）比大龄儿童（3%）更常见：相对风险5.6（95% CI = 4.2 - 7.5），并且与恶性疟（8.3%）相比，与间日疟（4.7%）显著相关：相对风险1.7（95% CI = 1.1 - 2.7）。惊厥是幼儿疟疾的重要并发症，即使在其他方面无并发症的疟疾中，也与恶性疟原虫感染特别相关。
