Convulsions in childhood malaria

Abstract

A retrospective survey was conducted of all 2911 children admitted with malaria to 4 provincial hospitals in eastern Thailand between 1977 and 1987. 96 (3·3%) had cerebral malaria of whom 21 (22%) died, 225(7·7%) had convulsions but were not comatose (4 died), and 2590 were conscious and had no fits (5 died).Thus the relative risk of a fatal outcome associated with convulsions, in the absence of cerebral malaria, was 9·2 (95% confidence interval [CI] = 2·5–34·1), P = 0·004. Overall, Plasmodium falciparum caused 81% of infections, P. vivax 16%, and 3% were mixed. Convulsions without cerebral malaria were more common in children under 3 years old (16%) compared with older children (3%): Relative risk 5·6 (95% CI = 4·2–7·5), and were significantly associated with falciparum malaria(8·3%) compared with vivax malaria (4·7%): Relative risk 1·7 (95% CI = 1·1–2·7). Convulsions are an important complication of malaria in young children, and are associated specifically with P. falciparum infection, even in otherwise uncomplicated malaria. © 1994 Oxford University Press.