Outcome of admitted malaria cases by treatment at Manicaland Provincial Hospital, Zimbabwe

Objective: To determine the outcome of admitted malaria cases according to age, late presentation, and antimalarial drug treatments received. Design: We reviewed all March 1994 hospital and laboratory records of patients with a clinical diagnosis of malaria. Setting: Manicaland Provincial Hospital. Subjects: 319 clinical malaria cases. Main Outcome Measures: Cases were classified as uncomplicated, complicated and unconscious. Results: Of the 319 cases reviewed, 213 slide examinations were done and 174 (82 pc) were slide positive. Of slide positive admissions, 91 (52 pc) were complicated and 37 (21 pc) were unconscious; 22 (13 pc) died. Case fatality was two pc in uncomplicated cases, six pc in complicated cases, and 46 pc in unconscious cases. Uncomplicated and complicated cases did as well on chloroquine (none of the 53 died) as on other treatments (four of the 76 died), whereas unconscious patients did poorly regardless of therapy received. Twelve patients received no therapy on their first hospital day and four died. There was no significant association between young age (age < 5 years) and complications or death, nor between late presentation (illness onset ≤ 3 days before hospital presentation) and complications or death.