Clinical and Hematological Criteria For Malaria Diagnosis In Endemic Area with Limited Resources

Objective: To devise a clinical and hematological criteria for malaria diagnosis in endemic area with limited resources Study Design: Prospective longitudinal study Place and Duration of Study: Combined military hospital Chhor, Sindh Pakistan from Feb 2021-Jan 2022. Methodology: 164 patients were enrolled using inclusion and exclusion criteria. Based on past experiences and unpublished data, specific clinical parameters of malaria were identified and given a score. Maximum score was 12. Clinical Score was calculated and verified for each patient by two clinicians. Later all the patients were subjected to Immuno-chromatographic tests by trained person to diagnose malaria. Clinical Score was then compared with subsequent ICT diagnosis of malaria. Cut-off was marked at score 7 as 151(92.7%) of patients presenting at and above this cut-off were confirmed cases of malaria. Results: 164 fever cases were included in the study. Out of 164 cases, 143 males (87.02%) and rest 21 females (12.08%). Mean clinical score was 9 ± 2. Mean age of patients were 28 ± 6 years. 151(92.7%) cases presented at score ≥ 7. Conclusion: Score ≥ seven be used in clinics of endemic area to assign cases suffering from malaria with confidence and can be treated empirically. This criteria can substitute ICT however cannot replace it. This criteria is very helpful where labs are not freely available or cannot be relied upon due to problems, specifically in peripheral health centre with limited resources.