Elesha S O, Adepoju F B, Banjo A A
Department of Morbid Anatomy, College of Medicine, University of Lagos, Nigeria.
East Afr Med J. 1993 May;70(5):302-6.
One hundred and forty seven cases of acute malaria were diagnosed at autopsy between 1988 and 1991 at the Lagos University Teaching Hospital (LUTH). In 67 (46.5%) cases death was attributed to cerebral malaria (CM). There was a gradual increase in the incidence of CM during the period under review. Both sexes were affected equally but more children than adults succumbed. The highest death rate was recorded in the age group 1-5 years with a peak in the 2nd and 3rd year. There were seven adults out of which one was intenerant white lady. Only one of the six adult Nigerians had travelled outside Africa and stayed away for about four years. The commonest presenting symptoms were: fever only, fever with convulsions and/or coma and fever with gastrointestinal symptoms such as vomiting and diarrhoea. The majority of the adults were comatose (five out of seven) without fever on admission. A review of the English literature on the diagnosis, pathogenesis and management of CM is also presented. The possible reasons of the rising incidence of CM in a holoendemic region such as Nigeria are discussed.
1988年至1991年期间，拉各斯大学教学医院（LUTH）经尸检诊断出147例急性疟疾。其中67例（46.5%）死于脑型疟疾（CM）。在审查期间，CM的发病率逐渐上升。男女受影响程度相同，但儿童比成人死亡更多。1至5岁年龄组的死亡率最高，在第2年和第3年达到峰值。有7名成年人，其中1名是流浪的白人女性。6名成年尼日利亚人中只有1人曾前往非洲以外地区并停留了约4年。最常见的症状是：仅发热、发热伴惊厥和/或昏迷、发热伴胃肠道症状如呕吐和腹泻。大多数成年人入院时昏迷（7人中有5人）且无发热。本文还对英文文献中关于CM的诊断、发病机制和治疗进行了综述。讨论了在尼日利亚这样的高度地方性流行地区CM发病率上升的可能原因。
