Hospital-based study of severe malaria and associated deaths in Myanmar.

ABSTRACT

The present study identifies factors that contribute to malaria deaths in township hospitals reporting large numbers of such deaths in Myanmar. Between July and December 1995, we identified a total of 101 patients with severe and complicated malaria by screening the cases admitted to hospital with a primary diagnosis of falciparum malaria. Unrousable coma and less marked impairment of consciousness with or without other severe malaria complications, in contrast to severe malaria anaemia, were associated with all malaria deaths. Adult patients with severe malaria were 2.8 times more likely to die than child patients, with the higher risk of death among adults probably being associated with previous exposure to malaria, delay in seeking treatment and severity of the illness before admission. In view of this, we consider that malaria mortality could be reduced by improving peripheral facilities for the management of severe malaria and providing appropriate education to communities, without stepping up vector control activities.

ABSTRACT

PIP Malaria threatens about 60% of Myanmar's population with morbidity and mortality. Factors are identified which contribute to malaria mortality in township hospitals reporting large numbers of such deaths in Myanmar. During July-December 1995, 101 patients with severe and complicated malaria were identified through the screening of cases admitted to hospital with a primary diagnosis of falciparum malaria. Unrousable coma and less marked impairment of consciousness with or without other severe malaria complications, in contrast to severe malaria anemia, were associated with all malaria deaths. Adult patients with severe malaria were 2.8 times more likely to die than child patients, with the higher risk of death among adults probably associated with previous exposure to malaria, delay in seeking treatment, and the severity of illness before admission. The level of malaria mortality could be reduced by improving peripheral facilities for the management of severe malaria and providing appropriate education to communities, without stepping up vector control activities.