الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 125 |  |  |
| | | from | 125 | | |
Abstract
M
alaria is an acute and chronic systemic illness caused by infection with Plasmodium parasites that lives part of its life in humans and part in female Anopheles mosquitoes. It remains one of the major killers of humans, population worldwide.
Egypt had eliminated malaria since 1998 until June 14, 2014. Between late May to mid-June, 19 locally-acquired P.vivax malaria cases were identified in one village of the Aswan Governorate.
To fulfill the aim of this work, we designed it to study clinical trends and prevalance of malaria in Abbasia Fever hospital over a period of two years.
This study was conducted in co-operation between Tropical Medicine Department, Faculty of Medicine, Ain Shams University and Abbasia Fever hospital
The current study was conducted on 200 Malarial patients admitted to Abbasia fever Hospital in Cairo to be treated according to the protocol of treatment of malaria which was approved by Ministry of Health in Egypt.
All of the studied cases were subjected to the following; full history taking specially (history of travelling to endemic areas of malaria), thorough clinical examination, laboratory investigations, serological tests (Rapid test and Blood film) for diagnosis of malaria.
The study shows that 62 patients were Egyptian recruited from malarial areas in Africa and 138 patients were other nationalities, and Sudan was the most malaria-infected place (46.5%) and Nigeria coming next in frequency (16%).
Regarding the clinical presentations of the studied group, 85.5% of patients had a fever as presenting symptom, the majority of patients experience sweating & rigors (85.5%) myalgia, jaundice (65%).,(86.5%) had vomiting, (23%) were DCL, (5.5%) had convulsion, (3.5%) with bleeding, (45%) had splenomegaly and (35.5%) had hepatomegaly.
In the current study, 56 patients (28%) were admitted at ICU presenting with severe malarial manifestation.
The past history of the studied cases was assessed, the study showed 135 patients (67.5) had a past history of malaria infection, 24 patients (12%) had taken chemoprophylaxis.
According to the treatment of malaria, the present study revealed that the best response in studied cases was to the mono-therapy.
Concerning the clinical outcome of the studied cases, most of the studied cases (189 patients) were cured in the sense of clinical and parasitological improvement
Regarding comparative results among the studied cases, complicated malaria was more frequent in male and non-Egyptian and pregnant women.
No significant difference between complicated and non-complicated cases regarding nethier history of exposure to malaria or receiving prophylaxsis.
Cases with complications significantly had lower GCS, more frequent jaundice, convulsions, splenomegaly, hepatomegaly, DCL, severe grade and ICU admission.
Index, ESR, creatinine, AST, ALT and total bilirubin was significantly higher in complicated case. Signifciantly lower platelets and Plasmosium falciparum type was more frequent among complicated cases
IV Artesunate & quinine and dialysis were significantly more frequent among complicated cases.
Short stay, death and poor prognosis were significantly more frequent among complicated cases.
So, Malaria should be considered as a cause of fever in relevant target patients. Severe malaria is a medical emergency. After full efficient clinical assessment and confirmation of the diagnosis by thick blood film, full doses of mono-therapy antimalarial treatment should be started without delay.
CONCLUSION
from the present study, we can conclude that:
Malaria should be considered as a cause of fever in relevant target patients.
Malaria disease is commoner in the younger age group
In Egypt, no endogenous malaria cases have been reported since1998 until 2014 a malaria outbreak was discovered in Aswan. Malaria cases in Egypt are usually coming from endemic area in Africa.
Mortality due to malaria disease is unusual, and may result from improper chemoprophylaxis and missed diagnosis or late treatment.
Monotherapy is preferable than Combined therapy (polytherapy) as it is more effective among the studied malarial cases.
Severity of the disease and complications are more common among advanced age>60y and in high malaria index.
.
RECOMMENDATIONS
All travellers to endemic countries must be given a health education about malaria, pathogenicity, preventive measures and proper chemoprophylaxis
We recommend immediate treatment for cases of plasmodium falciparum as it has poor prognosis
Pregnant women should not travel whenever possible to chloroquine-resistant malignant malaria areas as Risk of stillbirth, spontaneous abortion, and other adverse pregnancy outcomes is increasing in the setting of malaria, and pregnant travellers should be advised to defer travel until after delivery whenever feasible.