Malaria at the Chris Hani Baragwanath Hospital, Soweto
Perovic, O.; Crewe-Brown, H.H.; Blumberg, L.; Vallabh, W.; Kolobe, J.; Buqwana, A.; Gavalakis, C.; Loonat, S.B.
South African Medical Journal 90(4): 365-366
2000
ISSN/ISBN: 0256-9574 PMID: 10957920 Document Number: 516690
A retrospective survey of malaria cases diagnosed in a university hospital in Soweto, South Africa, showed that 2044 cases were confirmed between 1993 and 1998 inclusive. The number of admissions was relatively constant in 1993 and 1994 (207 and 198, respectively); however, in 1995 the number increased to 236 and in 1996 421 cases were diagnosed, representing a significant increase (P<0.05) in annual incidence. Further escalation was noted, with 473 patients diagnosed in 1997 and 509 in 1998. Most infections occurred between January and May each year during the summer rainfall season, with the largest number of cases presenting in January each year. The sex and age distribution showed an adult male predominance (58%) with children accounting for just 18% of cases. The mortality rate on limited analysis (1996 and 1997) was 2%. Plasmodium falciparum was present in 96% of cases. Percentage parasitaemia on admission ranged from <1% (45% of cases) to 50% (0.1%); 13% presented with hyperparasitaemia (>5%). The most common haematological abnormalities were thrombocytopenia (79%) and anaemia (61%). Most infections were imported from neighbouring regions, notably Mozambique, and the increase in cases is attributed to increased travel to and from an endemic area. A questionnaire survey in January-March 1995 revealed an average delay of 1 week between the onset of symptoms and diagnosis and treatment, with its attendant risk of complications and death.