DOI: 10.36347/sjams.2020.v08i11.035

Pages: 2599-2603

Total 100 cases of falciparum malaria, in the age group of 9 months to 12 years, were studied in the paediatric ward of Chittagong Medical College Hospital from March to August, 2003 with the objectives of studying the clinical presentations of falciparum malaria and their response to therapy, in children. Diagnosis of falciparum malaria was done by clinical examination as well as microscopical demonstration of Plasmodium falciparum in blood. Majority cases; 42 were within 4-6 years of age group, amongst them 61% were male and 39% female. Majority cases 31%had malaria during the month of April 17% in May. Regarding regional distribution of patients, most of the patients came from Hill-tracts, Fatikchari 12%, Rangunia 5%, Cox’sbazar 16% Chittagong 21%. Presenting symptoms included fever 100%, vomiting 15%, headache 7%, diarrhea 8%, altered consciousness 28%, respiratory distress 10%, dark urine 14%. Among febfile patients, clinicalstages was present, 29.1% percent cases developed cerebral malaria (10%), pulmorary oedema (21%) black-water fever signs, among complicated falciparum malaria were rise of temperature (100%), pallor (69%), hepatomegaly alone (56%), splenomegaly alone (33%), hepatosplenomegaly 23% and jaundice 22%. Among 6 cases of cerebral malaria, Blantyre coma seale score 3 of more was observed in 78.5% cases and score <3 in 21. 4% cases. The following signs were also observed: brisk tendon reflexes 2805%, positive babinski’s sign 21.4%, convulsion 52% pulmonary oedema 7.2%, abolished tendon reflexes 7.1% constricted pupil 7.1%, nuchal stiffness 14.2%, kernig’s sign 7.1%. Majority of patients 63% had parasite count 500-10,000 their peripheral blood and count was plenty in only 2% cases. Most of the patients were anaemic but 13% cases had sever anaemia. Initial treatment was started with chloroquine in 6 cases, among them 4 cases showed parasite clearance in peripheral blood after 3days of treatment. The rest 2 patients having persistent parasitaemia were