title: Severity of Malaria cases reported in urban and rural hospitals in Malaysia.
abstract: The age distribution, types of infection and clinical patterns of malaria were compared in patients admitted to an urban and a rural hospital. Analysis of the cases seen in urban setting characteristically indicated a relatively low transmission rate of the disease, whereas the mean inoculation rate in patients from the rural hospital was found to be at least twenty folds higher. Plasmodium vivax was the predominant causative species in the urban hospital (p = 0.01), infecting mostly adult (p = 0.001) males (p = 0.01). The geometric mean parasite count at 3432/microl among the urban patients was significantly higher than that in the rural patients at 1422/microl (p = 0.04). Coma and death were more common among the cases seen in the urban hospital (p = 0.003), while severe anemia was the significant complication in the rural setting. Overall, the provisional diagnosis of malaria was relatively low in the urban hospital (p = 0.02). The results from this study highlighted the need to define the extent of malaria in urban areas. This report attempts to identify the non-climatic determinants of the infection and, furthermore, to provide a more informed basis to describe the burden of the disease.
authors.affiliation: Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Amal R
authors.initials: AR
authors.lastname: Nimir
authors.forename: Noor Hayati Mohd
authors.initials: NH
authors.lastname: Isa
authors.forename: Chan Boon Tek
authors.initials: CB
authors.lastname: Eugene
authors.forename: Ismail Mohd
authors.initials: IM
authors.lastname: Ghauth
authors.forename: Fatmah Md
authors.initials: FM
authors.lastname: Salleh
authors.forename: Rozlida Abdul
authors.initials: RA
authors.lastname: Rahman
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008288:Malaria / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies