Clinicohematological and drug prescription details in children affected with malaria: A retrospective study from a tertiary hospital of an endemic region in India

Background: Malaria is a life threatening plasmodial infection transmitted by infected female Anopheles mosquitoes. It infects mainly the reticulo-endothelial system and causes derangement in the hematological parameters. This study was undertaken to study the Clinicohematological and audit of drug prescription in children affected with malaria attending a tertiary care hospital at Mangalore in Karnataka state of India. Materials and Methods: This was a retrospective study conducted in a tertiary care hospital among paediatric patients (<18 years of age) who were diagnosed with malaria during the study period. All the clinical details and other laboratory parameters were collected from the medical records and the lab parameters compared with control group, and statistical analysis was done. The mean, standard deviation was done for all the parameters and compared with control cases, using ANOVA /Kruskal Wallis test. The p value < 0.05 were considered as significant. Results: A total of 290 children (males 182: females 108, 2:1) were included in the study, 204 (70.3%) patients had P. vivax, mixed malaria 71 (24.5%) and 15 (5.2%) had P. falciparum. The Majority of the patients (179, 61.72%) belonged to the age group of 11-16 years (Table 1). Among the 290 children diagnosed with malaria, all had fever. Vomiting (89, 30.7%) was second most common symptom. The haemoglobin, and total leucocyte count was reduced in all patients, whereas the Erythrocyte Sedimentation Rate (ESR) was significantly higher in the infected cases. There was significant thrombocytopenia seen mainly in falciparum group. The liver and renal functions were deranged in infected cases. Among the 204 vivax group of patients, chloroquine (187, 91.67%) was the most frequently administered drug. All patients with P. falciparum and mixed group were treated with Artemether. Anti-hypnozoites drug, i.e. Primaquine were administrated to all vivax and mixed malarial patients as per guidelines for 14 days. Conclusions: The study area is a well document endemic region for vivax malaria and our results agreed to previous reports in this study with the paediatric age group. The audit of drug prescriptions suggests that the drugs prescribed were as per guidelines in majority of the children.