PREDICTION OF OUTCOME IN SEVERE MALARIA BY GCRBS SCORE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 93
Abstract
BACKGROUND Malaria is a major cause of morbidity and mortality in the tropical and subtropical regions of the world. Our state Odisha alone accounts for 27% of all malaria cases and 18% of all malaria deaths. Since severe malaria is associated with high mortality, a scoring system for predicting the outcome (like GCRBS) will be of great help for a treating clinician in identifying the patients needing more intensive medical care and prognosticate chances of survival. MATERIALS AND METHODS A hospital-based descriptive study was conducted to include all cases of severe malaria in patients <14 years of age admitted to the Paediatric Department of MKCG Medical College and Hospital during the study period from October 2014-September 2016. The exclusion criteria included cases which were suspected malaria cases having negative lab diagnosis. The diagnosis of malaria was confirmed by blood tests (microscopic and RD test). Then a detailed clinical evaluation of each patient and laboratory investigations were done following which GCRBS scoring was given to each patient. Clinical findings, haematological and biochemical investigations were analysed in SPSS V24 software, and Chi Square analysis along with Odds ratio were calculated to know the statistical significance and the sensitivity and specificity of the GCRBS score was calculated. RESULTS A total of 185 cases of severe malaria as per WHO criteria were included in the study. In which, 107 (58%) were male and 78 (42%) were female. The age of the patients ranged from 3 months to 14 years. Majority were in <5 years age group (51.9%). Fever is the most common presenting symptom (97.8%). The most common clinical manifestation was severe anaemia (69.7%). The causative agent was P. falciparum in 81.1%. The overall mortality in the study was 9.7%. Higher the GCRBS score poorer was the outcome. As the scores increase, sensitivity of predicting mortality is decreasing and specificity is increasing. GCRBS has a good discriminatory ability between survivors and non-survivors. CONCLUSION The GCRBS score seems to be a very good working tool as it is very easy to calculate and easy to remember. Like GCS score system which is popular among doctors, this too will help in predicting outcome of severe malaria in children and indirectly reducing the mortality.
Authors and Affiliations
Sunil Kumar Agakwalla, Nasreen Ali, Vishnu Anand
Keywords
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- EP ID EP279341
- DOI 10.14260/jemds/2017/1443
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