FACTORS ASSOCIATED WITH DEATHS IN SEVERE FALCIPARUM MALARIA NATIONAL REFERRAL HOSPITAL HONIARA, SOLOMON ISLANDS

Severe falciparum malaria is one of the leading causes of increased morbidity and mortality at the National Referral Hospital that accounts for 20 to 30% of hospital admissions. The study was a retrospective descriptive study looking at severe falciparum malaria in the period of January 2006 to January 2008. The case folders of 110 patients admitted to the National Referral Hospital (NRH) with severe falciparum malaria was studied to determine the factors associated with deaths in severe falciparum malaria. Mortality was measured by cases that died of severe falciparum malaria. The Epi -Info software was used for data analysis and chi-square L II test and p values were used for the statistical analysis. Results: The average number of admission was 55 cases annually. The case fatality rate was 17% for 2006 and 14% for 2007. 89% of cases of severe malaria occurred in the age group 13 -50 years. The mean age of the
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live patients was 30 years and the death patients was 42 years (p =0.0022). Relatively more males (57%) had severe malaria as compared to females (43%). Significant correlation with high
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probability of severe adverse outcome was seen in those who were from the rural areas and those who were referred from other peripheral clinics and health centres. The symptoms of severe malaria did not correlate with probability of dying (p > 0.05), however, the following vital signs showed significant correlation; heart rate (p =0.0318), oxygen saturation (O.OOOO), CBG (0.01) and MAP (0.05). The physical findings pertaining to respiratory, neurological and renal systems showed significant correlation with adverse outcome of severe falciparum malaria. Cerebral Malaria, malaria related multi-organ involvement or failure and ARDS were the commonest cause of mortality. The prognostic criteria for identifying patients that are likely to do badly and for whom intensive care in their management should be instituted was determined in the study.