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10.1093/qjmed/hcg059 http://scihub22266oqcxt.onion/10.1093/qjmed/hcg059 C5612393!5612393 !12702784     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=12702784 &cmd=llinks): Failed to open stream: HTTP request failed! 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Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description |pdf=|usr=}}{{12702784 }} gab.com Text Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description JO: QJM http://www.kidney.de/pget.php?&tw=1&pmid=12702784 #FOAvip BACKGROUND: Cerebral malaria is commonly diagnosed in adults in endemic areas in Africa, both in hospitals and in the community. This presents a paradox inconsistent with the epidemiological understanding that the development of immunity during childhood confers protection against severe disease in adult life. AIM: To establish the contribution of Plasmodium falciparum infection in adults admitted with neurological dysfunction in an endemic area, to assess the implications of an admission clinical diagnosis of 'cerebral malaria' on the treatment and clinical outcome, and to describe the clinical features of patients with malaria parasitaemia. DESIGN: Prospective observational study. METHODS: We studied adult patients admitted with neurological dysfunction to Muhimbili National Hospital, Dar-es-Salaam, Tanzania from October 2000 to July 2001. A full blood count was done and serum creatinine, blood glucose and P. falciparum parasite load were measured. RESULTS: Of 199 patients (median age 34.6 years), 38% were diagnosed as 'cerebral malaria' on admission, but only 7.5% had detectable parasitaemia, giving a positive predictive value of 13.3%. Only 1% fulfilled the WHO criteria for cerebral malaria. The prevalence of parasitaemia (7.5%) was less than that observed in a group of asymptomatic controls (9.3%), but distribution of parasite densities was higher in the patients. Mortality was higher in patients with no parasitaemia (22.3%) than in those with parasitaemia (13%). DISCUSSION: Cerebral malaria was grossly overdiagnosed, resulting in unnecessary treatment and insufficient investigation of other possible diagnoses, which could lead to higher mortality. Extension of this misperception to the assessment of cause of death in community surveys may lead to an overestimation of the impact of malaria in adults. Twit Text FOAVip Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description ????QJM http://www.kidney.de/pget.php?&tw=1&pmid=12702784 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=12702784 #FOAvip English Wikipedia <ref>{{Cite pmid|12702784 }}</ref> Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description #MMPMID12702784 Makani J ; Matuja W ; Liyombo E ; Snow RW ; Marsh K ; Warrell DA QJM 2003[May]; 96 (5 ): 355-62 PMID12702784 show ga BACKGROUND: Cerebral malaria is commonly diagnosed in adults in endemic areas in Africa, both in hospitals and in the community. This presents a paradox inconsistent with the epidemiological understanding that the development of immunity during childhood confers protection against severe disease in adult life. AIM: To establish the contribution of Plasmodium falciparum infection in adults admitted with neurological dysfunction in an endemic area, to assess the implications of an admission clinical diagnosis of 'cerebral malaria' on the treatment and clinical outcome, and to describe the clinical features of patients with malaria parasitaemia. DESIGN: Prospective observational study. METHODS: We studied adult patients admitted with neurological dysfunction to Muhimbili National Hospital, Dar-es-Salaam, Tanzania from October 2000 to July 2001. A full blood count was done and serum creatinine, blood glucose and P. falciparum parasite load were measured. RESULTS: Of 199 patients (median age 34.6 years), 38% were diagnosed as 'cerebral malaria' on admission, but only 7.5% had detectable parasitaemia, giving a positive predictive value of 13.3%. Only 1% fulfilled the WHO criteria for cerebral malaria. The prevalence of parasitaemia (7.5%) was less than that observed in a group of asymptomatic controls (9.3%), but distribution of parasite densities was higher in the patients. Mortality was higher in patients with no parasitaemia (22.3%) than in those with parasitaemia (13%). DISCUSSION: Cerebral malaria was grossly overdiagnosed, resulting in unnecessary treatment and insufficient investigation of other possible diagnoses, which could lead to higher mortality. Extension of this misperception to the assessment of cause of death in community surveys may lead to an overestimation of the impact of malaria in adults. |Adolescent [MESH] |Adult [MESH] |Aged [MESH] |Aged, 80 and over [MESH] |Diagnostic Errors/*statistics & numerical data [MESH] |Female [MESH] |Humans [MESH] |Incidence [MESH] |Malaria, Cerebral/*diagnosis/epidemiology/mortality [MESH] |Male [MESH] |Middle Aged [MESH] |Prospective Studies [MESH] |Sensitivity and Specificity [MESH] |Tanzania/epidemiology [MESH]Admission diagnosis of cerebral malaria in adults in an endemic area o(epmc).pdf DeepDyve Pubget Overpricing