Muhammad Akbar Nizamani, M Hassan A Memon.
Cerebral Malaria in children a study of 50 cases.
Pak Paed J Jan ;19(1):1-7.

Fifty cases of cerebral malaria in children admitted at pediatric units at Liaquat Medical College Hospital, Jamshoro (LMCH) were studied prospectively over a period of 2 years. Cases fulfilled the diagnostic criteria set by WHO of unarousable coma, asexual parasitemia and no other demonstrable cause of coma. Total malaria related admissions were 5.5% and definite cerebral malaria (CM) accounted for 0.64% of total admissions. Sixty six percent children presented with fever, fits and unconsciousness and 20% presented with fever and unconsciousness, 80% children were comatose from grade-II to N at the time of admission. Eight percent children died and 22% developed neurological sequelae. I/V chloroquine was effective clinically in 70% cases. Thirty six percent patients showed late parasite clearance with more neurological sequelae. Infancy, deep coma, longer history (>5 days), gross anemia, witnessed convulsions, decerebration, shock, hypoglycemia and hyperparasitaemia are associated with poor prognosis. Poverty, malnutrition, non-immunization are background factors which indicate lack of health care. R-II type chloroquine resistance may be responsible for increased morbidity.

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