Severe Falciparum Malaria in Children at Somdejt Prachaotaksin Maharaj Hospital
Benjasin Niphakasem MD*
Affiliation : * Pediatric Unit, Somdejt Prachaotaksin Maharaj Hospital, Tak
Objective : Evaluate WHO guideline for the treatment of severe malaria.
Materials and Methods : A retrospective study in 41 pediatric patients who were admitted and diagnosed
as severe malaria in Somdejtprachaotaksinmaharaj Hospital between July 2003 and June 2006 was per-
formed.
Results : Most patients were older than 5 years (83%). The common clinical features and complications were
cerebral malaria (12%), severe anemia (7.3%), metabolic acidosis (7.3%), acute renal failure (4.8%) and
pulmonary edema (4.8%). These were not different from other reports. Hypoglycemia and hemoglobinuria
were not found. 58.5% of the children were classified as having increased risk of dying. All of them received
intravenous artesunate and oral mefloquine with improvement. None of them died. Paracitic clearance time
was about 2.6 days, fever clearance time was about 3.4 days and resistant type1 was about 4%.
Conclusion : Intravenous administration of antimalarial drug is essential for the group of children at in-
creased risk of dying and artesunate plus mefloquine is effective.
Keywords : Severe falciparum malaria, Clinical feature, Complications, Treatment
