Factors associated with cerebral malaria.
We conducted a retrospective unmatched case-control study using the medical records of patients admitted to the Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand to investigate factors associated with cerebral malaria. The records of 137 patients with severe Plasmodium falciparum without cerebral malaria and 35 patients with cerebral malaria hospitalized during 1997-2005 were reviewed and compared. Ten factors associated with cerebral malaria were identified: pulmonary edema [odds ratio (OR)= 13.8; 95% confidence interval (CI): 1.3-143.2], splenomegaly (OR=3.7; 95% CI: 1.3-44.7), fever (OR=3.3; 95% CI: 1.7-14.3), day 1 malarial density < or = 249,999/microl (OR=1.6; 95% CI: 1.1-14.6), day 2 malarial density < or =249,999/microl (OR=3.4; 95% CI: 1.3-35.1), dyspnea (OR=1.4; 95% CI: 1.2-12.1), hepatomegaly (OR=1.8; 95% CI: 0.2-12.1), being a referred patient (OR=1.3; 95% CI: 1.0-2.2), a higher systolic blood pressure (OR=1.2; 95% CI: 1.0-2.1) and a higher body mass index (OR=1.6; 95% CI: 1.0-2.6). Pulmonary edema was the strongest factor associated with cerebral malaria in our study. Clinicians who treat patients with severe Plasmodium falciparum malaria should be aware these factors are associated with cerebral malaria.
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Bipin
B
Adhikari
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Noppadon
N
Tangpukdee
Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Srivicha
S
Krudsood
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Polrat
P
Wilairatana
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000627:therapeutic use; D000077332:Artesunate; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D010963:Plasmodium falciparum; D012189:Retrospective Studies; D013785:Thailand
D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D015767:Mefloquine