Dr. Khadija Tahira, Dr. Amna Amir, Dr. Areeba Saleem
Aim: The purpose of this study was to compare the spectrum of clinical symptoms, hospital history, and treatment outcomes of children diagnosed with different types of malaria. Methods: This descriptive cross-sectional study was conducted in the Pediatric department of PIMS Hospital, Islamabad for one-year duration from March 2019 to March 2020. In children 1 to 14 years of age diagnosed with malaria by peripheral smear or immuno-chromatography. Biological data, clinical presentation, and outcome were recorded. All children received supportive and anti-malarial treatments. Results: Of the 2,357 children who reported to the emergency department, 400 of them developed malaria parasitemia. Two-thirds (65.2%) were infected with Plasmodium falciparum. In the falciparum group, the symptom age was often below 5 years (70%), in 90.4% intermittent fever was observed; jaundice in 21.8%, viscera in 62%, thrombocytopenia in 61%, and the neurological picture in 11.5% of cases. 16 children (6.1%) died from complications of malaria. Plasmodium vivax (P.v) induced parasitemia was found in 114 children (28.5%). In vivax patients, the common age of symptoms was less than 5 years (69%), intermittent fever was reported in 86.8%; jaundice in 20.2% and thrombocytopenia in 70%. Overall, 25 (6.2%) children were diagnosed with mixed falciparum and vivax infection. In this group, jaundice occurred in 52% of cases, and spleen enlargement in all children. The mortality in mixed infections was high compared to the falciparum and vivax groups (p-0.04). Conclusion: It was clear from this study that malaria can manifest itself in many ways like any other disease and can mislead the diagnosis. The most common symptoms were fever, viscera and thrombocytopenia. Mixed infection resulted in higher mortality. Keywords: Malaria, Clinical presentations, Complication, Outcome, Mortality, Children.