Analysis of different clinical criteria in malaria patients in Papua New Gwinea

To assess the validity of different clinical criteria in malaria patients, a small study including 92 children presented with fever or history of fever were examined in a highly endemic area of Papua New Gwinea. In 21 children parasitaemia was confirmed by microscopy examination of thick and thin smear stained with Giemsa method (9 cases of Plasmodium falciparum, 8 cases of Plasmodium vivax and 4 cases of mixed invasion Plasmodium falciparum and Plasmodium vivax). Only 4 from different 39 criteria analyzed in children with history of fever or hot skin showed significant association with parasitaemia (conscious disturbances, severe wasting, enlarged spleen and diarrhoea), however none of the criteria presented high sensitivity and could serve as good predictors for parasitaemia accept two (first and second one). These findings help to realize the importance of laboratory examination in diagnosis of malaria and explain difficulties in confirming or exclusion of malaria where microscopy is not available.