Published: 2018-05-25

Multiorgan dysfunction (MOD) in falciparum malaria in children: a study from high endemic area of Southern Odisha

Niranjan Mohanty, Debasis Patro, Subhranshu Sekhar Dhal


Background: To find out the prevalence of multiorgan dysfunction in cases of severe falciparum malaria in children, correlating the organ dysfunction in different age group and relationship with case fatality rate (CFR).

Methods: This prospective cross-sectional study was conducted from Jan 2014 to June 2016 in the Department of Pediatrics, Maharaja Krushna Chandra Gajapati medical college and hospital (MKCG MCH), Berhampur, Odisha, India. Total 340 cases belonging to <14 yrs having severe malaria (as per the WHO criteria) were included in the study. Mixed malaria and Plasmodium falciparum (Pf) positive cases having other significant disease e.g. chronic hemolytic anaemia, cardiac, renal or other chronic diseases were excluded. The study subjects were thoroughly screened for presence of organ dysfunction clinically and by appropriate laboratory tests and analysed.

Results: Out of 340 subjects, maximum no of cases (56.76%) were found in >5yr age group. Hyperparasitemia (>10%) was detected in 12.35% cases. Cerebral malaria was most common organ dysfunction found in 1-5 years, followed by anaemia in 5-10 years, acute renal failure (ARF) in 10-14 years age group. Multiorgan dysfunction (MOD) was detected in 32.94% cases of severe malaria. Overall CFR was 8.82%, being directly proportional to no. of organ involvement, 31.81% with 4 organs and 100 % with five organs involvement respectively which was statistically significant.

Conclusions: MOD is of grave outcome in severe Pf malaria increasing the case fatality rate proportionate to number of organs involved.


Case fatality rate, Endemicity, Multiorgan dysfunction, Pf malaria

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