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Clinical symptoms, treatment and outcome of Highlands malaria in Eldoret (2,400 m a.s.l.) and comparison to malaria in hyper-immune population in endemic region of South Sudan

Abstract number: 1733_274

Farkasova A., Seckova S., Nagyova Z., Kolenova A., Olejcekova P., Sabo I., Gabrhelova L., Krcmery V., Kisac P., Kalavsky E., Kiwou M., Taziarova M., Bukovinova P., Ocenas M., Kralova J., Kutna K., Mykyta J., Velganova M., Augustinova A., Pivarnik M., Duris M., Uhercik L., Benca J., Pastekova T.

Aim of the study and Introduction: Malaria should not be present in altitudes more than 1,800 m a.s.l. However due to global warming, so called Highlands malaria (HM) sporadically occurs up to 2,000 m a.s.l.

The purpose of this study is compare of clinical picture and prognosis of HM and compare it to malaria in endemic region of South Sudan (endemic malaria – EM) among hyper-immune population.

Patients and Methods: Analysis of HM from November 2005 to November 2006 were reviewed (64 cases), symptoms, therapy and outcome were compared to 215 cases of EM occurring in Gordhim, South Sudan, where malaria is endemic. Imported cases from Rift Valley to Eldoret were excluded.

Results: Analysis of 64 cases of sporadic HM showed mild clinical picture – fever 100%, chills up to 80%, headache 15%, gastrointestinal symptoms were present in 35.6%, respiratory symptoms in 64.4%. Only 1 case (1.6%) of cerebral malaria occurred. Amodiaquine in 81% and amodiaquine/arthesunate in 19% were used for therapy with only 1 failure.

Analysis of 215 cases of EM showed more severe symptoms: 58 (27%) had severe clinical course, 10 patients (4.7%) cerebral, 1 patient (0.5%) lung edema, severe anaemia with hemoglobinuria 21.8%, seizures 8 patients (3.7%), severe hypoglycaemia 12 (5.75%). Amodiaquine plus artesunate was used for therapy, in some cases, arthemeter or/and quinine were prescribed. 17 patients in Sudan (4%) died, mostly on CNS and respiratory failure due to cerebral malaria and/or severe anaemia.

Conclusion: Sporadic malaria occurs also in heights up to 2,400 m a.s.l. We documented 64 cases of non-imported malaria in population living above 2,000 m a.s.l., probably due to global warming in Equatorial Africa. Clinical symptoms despite of high immunity among population were much severe in endemic area of South Sudan (27%) including 17 deaths (4%) in comparison to no deaths and 1.6% occurrence of severe malaria in semi-immune population of Eldoret (Highlands malaria).

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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