Clinical presentation of childhood malaria in Savannakhet province, Lao PDR.

A descriptive study on the clinical presentation of childhood malaria was conducted in Savannakhet Province, Lao People's Democratic Republic. It is aimed to describe the clinical features and to determine the association between the severity of malaria and the initiation or delay of treatment. A total number of 92 children 1-14 years of age with confirmed malaria diseases were enrolled in this study. Fifty-six cases (60.9%) had illness for less than 3 days before hospitalized and 36 cases (39.1%) for more than 3 days. Twenty-nine cases (31.5%) had self antimalarial medication before admission (9 cases of chloroquine, 16 cases of quinine and 4 cases of artesunate). Ten cases (10.9%) had abnormal consciousness of which 7 cases (7.6%) had confusion but responded to verbal command and 3 cases (3.3%) were in coma not respond to painful stimuli but had reflex. Two cases 2.2%) had convsulsions, 11 cases (12.0%) had dehydration, 47 cases (51.1%) had vomiting, 18 cases (19.6%) had hepatomegaly and 19 cases (20.7%) had splenomegaly. There was a statistically significant association between consciousness levels and the duration of illness before admission < or = 3 days and > 3 days (p = 0.01) while there is no significant difference between parasitemia density and the duration of illness before admission (p > 0.05).

Childhood malaria in the Lao People's Democratic Republic.

The idea that malaria in South-East Asia is synonymous with adult malaria is questioned in this paper. In the Lao People's Democratic Republic, community-based malariometric data were collected in Savannakhet Province, which shares borders with Viet Nam in the east and Thailand in the west. The data indicate that endemic malaria is rural and stable in large areas of the province. In these areas, which are rarely subject to malaria control, there is significant childhood malaria. A little more than one-quarter of individuals examined in mass blood surveys carried out in the peak malaria season were parasite-positive. Unlike other studies in the region reporting a declining risk of positive parasitaemia with age, thus suggesting immunity consistent with high and prolonged exposure to malaria, the communities studied in the Lao People's Democratic Republic did not show the expected acquisition of immunity. Further community-based studies on this matter are therefore warranted.