• Users Online: 78
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
RESEARCH ARTICLE
Year : 2012  |  Volume : 49  |  Issue : 3  |  Page : 157-163

Incidence, management, and reporting of severe and fatal plasmodium falciparum malaria in secondary and tertiary health facilities of alipurduar, india in 2009


1 West Bengal Public Health & Administrative Services, Government of West Bengal, Kolkata, India
2 Department of Epidemiology, University of North Carolina, Chapel Hill, USA
3 Field Epidemiology Training Programme, National Institute of Epidemiology, Chennai, India

Correspondence Address:
Manoj V Murhekar
National Institute of Epidemiology (ICMR), R-127, Third Avenue, Tamil Nadu Housing Board, Ayapakkam, Chennai–600 077
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

Background & objectives: The proportion of malaria cases that are complicated and fatal are not well described in India. Alipurduar sub-division of Jalpaiguri district in West Bengal is highly endemic for malaria. We constructed a retrospective cohort of severe malaria patients admitted in the secondary and tertiary care facilities in Alipurduar to determine the incidence, assess the management, and evaluate the reporting of severe and fatal malaria. Methods: We reviewed routine surveillance data and the case records of all the malaria patients admitted in all secondary and tertiary care facilities, both public and private. We defined severe malaria cases as Plasmodium falciparum infection with clinical signs and symptoms of organ involvement in a resident of Alipurduar admitted during January to December 2009. We compared clinical and demographic characteristics of severe malaria cases that died with those who survived. We also reviewed human resources and laboratory facilities available for the treatment of severe malaria in these health facilities. Results: During 2009, 6191 cases of P. falciparum in Alipurduar were reported to the malaria surveillance system. We identified 336 (5.4%) cases of severe malaria among which 33 (9.8%) patients died. Four malaria deaths were also recorded from primary health centres. Only 17 of the 37 (46%) total deaths recorded were reported to the routine surveillance system. Most severe cases were males (65%), aged >15 years (72%), and nearly half were admitted to secondary care hospitals (48%). In multivariate analysis, the risk factors associated with death included increased delay fever onset and hospitalization, treatment in a secondary level hospital, younger age, and multi-organ involvement. The secondary level public hospital had too few physicians and nurses for supporting severe malaria patients as well as inadequate laboratory facilities for monitoring such patients. Conclusions: Severe and fatal malaria continue to burden Alipurduar and record keeping in health facilities was poor. Many malaria deaths were not routinely reported even in the public sector. Improved surveillance and increased human and laboratory resources are needed to reduce malaria mortality.


[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed238    
    Printed11    
    Emailed0    
    PDF Downloaded29    
    Comments [Add]    

Recommend this journal