Clinical Profile and Predictors of Severe Malaria: A Study from Two Tertiary Care Centers in Istanbul

Objective: This study aimed to determine discriminating findings of severe malaria cases compared with other cases. Methods: Epidemiological, laboratory, and clinical features of the patients were collected retrospectively from two tertiary centers. The diagnosis was established in all cases by the detection of trophozoite and/or gametocyte forms of the parasite in the microscopic examination. "Severe malaria" with a serious clinical course was defined according to 2015 World Health Organization data. Results: This study included 94 patients with imported malaria composed of 85 male (90.4%) and 9 female (9.6%) patients with a mean age of 32.4 +/- 4.56 years. P. falciparum (n=72, 76.6%) and P vivax (n=15, 15.9%) were the most frequently identified agents. Of all cases, 12.7% (n=12) were defined as severe malaria. The frequency of abdominal pain, diarrhea, splenomegaly, and deep thrombocytopenia were significantly higher in severe malaria cases than in other cases (p=0.002; p=0.001; p=0.046; p=0.041, respectively). Conclusion: The frequencies of abdominal pain, diarrhea, splenomegaly, and deep thrombocytopenia were significantly higher in severe malaria cases than in other cases. These factors can be accepted as predictors of severe malaria.