A preliminary study of the clinical features of malaria infections in Sri Lanka

Abstract

This study analyses the clinical features of 50 consecutive admissions of malaria patients to the University Medical Unit, GHC during the period of 3rd September 1986 to 31st December 1986. A detailed history was taken and a clinical examination was performed on these patients and the diagnosis was confirmed by examination of thin blood films. Of the 50 cases studied 29 (58%) were P. falciparum infections, 17 (34%) were P. vivax and 4 (8%) mixed infections of P. fulciparum and P.vivax. The c1asiscal tertian pattern of fever, was observed in 17% of P. falciparum and 77% of P. vivax infections. The diurnal distribution of fever episodes in these patients appeared to be different for P. falciparum and P. vivax infections. In both patients P. falciparum and P. vivax chills were a consistent feature accompanying "fever attacks" whereas rigors were more associated with vivax infections. Pallor was observed in 28% and Jaundice in 16% of all patients. Lymphadenopathy was prominently absent in all the cases. Hepatomegaly was found in 20 (40%) and splenomegaly ini10 (60%). CNS signs were observed in 9 patients (18%). Truncal ataxia was the almost frequent of these signs (56%). 6% of the patients were treated with Fansilar based on clinical and parasitological evidence of chloroquine resistance. One patient died of necrotising enterocolisis. This investigation is being continued to include a large sample and with a viewto characterizing the clinical picture of the 2 malaria species present in Sri Lanka.