Nairobi Hospital, Kenya: the management of nonimmune P. falciparum malaria abroad.
A retrospective analysis of all malaria cases admitted to the Nairobi Hospital was performed by reviewing patient records. Six hundred and three cases were recorded between the period of January 1987 and July 1990 (43 months). The mean age of the patients was 32.5 years and 57.5% were male. Although 81.4% were permanent residents of Kenya, only 18.2% could be said to have lived in a malarial zone. One-quarter of the patients (25.6%) admitted having had a previous episode of malaria, and 57.7% were taking regular chemoprophylaxis. The most common presenting symptoms were fever, headache, vomiting and myarthralgia; the most commonly recorded accompanying signs were jaundice and splenomegaly. Sixty patients met the criteria for severe malaria. During their hospital stay, six patients (1%) died; five of whom were severely ill from the time of for the USA and UK, especially as it represents a selected population of the more serious malarial cases admitted to the hospital. Therefore, it may indeed represent clear evidence to support the hypothesis that a high index of suspicion combined with early diagnosis and treatment will result in improved outcome. Comparative features illustrating these points are presented. As the malaria parasite, P. falciparum, has dynamic antimalarial sensitivity and as more travelers are under threat from this disease, it is vital that ignorance of this danger should not be allowed to put individuals at risk for death. Continuing education of both the traveling public and the medical profession is the only way that both parties will shoulder their respective responsibilities.
Nevill
C G
CG
Department of Community Health, African Medical Research Foundation (AMREF), Nairobi.
Slingerland
W
W
Greve
M
M
Dappen
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D014195:Travel; D016896:Treatment Outcome
D000962:Antimalarials