title: Autopsy study of febrile deaths during monsoon at a tertiary care institute in India: Is malaria still a challenge?
abstract: BACKGROUND
  To utilise an autopsy-based approach to study the febrile deaths and deaths due to malaria during monsoon period of three years at a tertiary care teaching hospital in Mumbai, India.
  
  
  METHODS
  All autopsies done at the hospital during monsoon period from 2005 to 2007 when fever was the main presenting symptom were included in the study. Monsoon period was defined from June to September. A study on the duration of hospital stay of malaria deaths was also attempted.
  
  
  RESULTS
  There were 202 autopsies of febrile illness during the study period. Malaria resulted in 20.8% of the deaths besides other causes. A majority of deaths had intrapulmonary haemorrhages as the only pathological finding. Incidence of malaria deaths was more during monsoon period than the non-monsoon period. Plasmodium falciparum was the most common species responsible for malaria deaths while cerebral malaria was the most common mode of death. In 27% of the cases, post-mortem examination helped to arrive at the correct final diagnosis. In 88.1% of the cases, malaria deaths occurred within the first 24 hours of admission to the hospital.
  
  
  CONCLUSIONS
  The study reiterates the fact that malaria remains a preventable but major cause of death in India, predominantly during the monsoon period. The study also emphasises the importance of developing treatment protocols for malaria during such crucial times besides reinforcing the existing preventive measures.
authors: Department of Pathology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
authors: Anurag
authors: A
authors: Gupta
authors: Department of Pathology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
authors: Varsha
authors: V
authors: Dhume
authors: Department of Pathology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
authors: Gururaj Venkatesh
authors: GV
authors: Puranik
authors: Department of Pathology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
authors: Vikas
authors: V
authors: Kavishwar
keywords: Autopsy; cerebral malaria; death; fever; malaria; monsoon rains
references: Indian J Med Res. 2009 Mar;129(3):299-304
references: 19491423
references: Indian J Malariol. 1995 Dec;32(4):140-52
references: 8867060
references: Lancet. 1997 May 24;349(9064):1498-504
references: 9167458
references: Indian J Pathol Microbiol. 1996 Dec;39(5):477-9
references: 9002376
references: Clin Infect Dis. 2011 Aug;53(4):349-55
references: 21810747
references: Nature. 2005 Mar 10;434(7030):214-7
references: 15759000
references: Science. 1996 Nov 1;274(5288):740-3
references: 8966556
references: Acta Trop. 2012 Mar;121(3):267-73
references: 22142788
references: Malar J. 2008 Jul 11;7:126
references: 18620560
references: Tanzan J Health Res. 2009 Oct;11(4):210-8
references: 20734701
references: Indian J Pathol Microbiol. 2003 Jan;46(1):17-9
references: 15027711
references: Indian J Pathol Microbiol. 1996 Dec;39(5):391-414
references: 9002368
references: Indian J Malariol. 1997 Sep;34(3):164-70
references: 9519571
references: J Neurol Neurosurg Psychiatry. 2000 Oct;69(4):433-41
references: 10990500
references: Malar J. 2009 Oct 12;8:227
references: 19822005
references: Indian J Malariol. 1995 Sep;32(3):119-28
references: 8936294
references: Am J Trop Med Hyg. 2004 Oct;71(4):451-6
references: 15516642
references: Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):1-11
references: 11425172
references: J Assoc Physicians India. 2012 Oct;60:15-8
references: 23777019
references: J Commun Dis. 1997 Jun;29(2):175-8
references: 9282520
references: PLoS Comput Biol. 2010 Sep 02;6(9):e1000898
references: 20824122
references: Lancet. 2010 Nov 20;376(9754):1768-74
references: 20970179
references: Lancet. 2010 Nov 20;376(9754):1716-7
references: 20970180
references: Am J Trop Med Hyg. 2010 Jun;82(6):1010-6
references: 20519593
references: J Vector Borne Dis. 2006 Mar;43(1):29-33
references: 16642783
references: J Vector Borne Dis. 2003 Sep-Dec;40(3-4):109-11
references: 15119081
references: Southeast Asian J Trop Med Public Health. 1999 Jun;30(2):243-5
references: 10774686
references: Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):69-78
references: 18165477
references: Cleve Clin J Med. 2008 Apr;75(4):258, 260, 264-5 passim
references: 18491433
references: Malar J. 2009 May 07;8:93
references: 19419588
references: Indian J Malariol. 1995 Jun;32(2):70-5
references: 7589731
references: Indian J Med Res. 2001 May;113:186-91
references: 11968953