Profile and outcomes of patients with acute complications of malaria presenting to an urban emergency department of a tertiary hospital in Tanzania.

objectivesIn Tanzania, malaria ranks number three among the top ten causes of deaths in all age groups, however little is known about the utilisation of emergency department by patients with complications of malaria. We describe clinical presentation, resource utilization, and outcomes of acutely ill patients with complications of malaria presenting to an urban emergency department (ED) in Tanzania.

resultsWe screened 405 patients which physicians had a clinical suspicion or diagnosis of malaria at ED. We enrolled 184 (45.5%) patients meeting WHO clinical and laboratory definition of malaria. The median age was 22 years (interquartile range 22-33 years), 105 (57%) were male, and overall 124 (67.4%) were self-referral. The use of insecticide treated nets (ITNs) in this group was 125 (67.4%). Fever 125 (67.9%), headache 56 (30.4%) and general body malaise 41 (22.2%) were the top three frequent complains, while tachycardia 83 (42.9%) was the most frequent abnormal vital sign. Overall, 21 (11.4%) patients had severe anaemia and 21 (11.4%) had abnormal renal function test. In ED 121/184 (65.8%) patients received antimalarial, 74/184 (40.2%) received antibiotics, 6/184 (3.3%) received antipyretic/analgesic and 5/20 (25%) patients with severe anaemia received blood transfusion. Overall, 99/184 (53.8%) patients were hospitalized, 3 (1.6%) died at the ED, and the overall hospital morality was 3.8%. Overall we found a substantial burden of patients with complications of malaria presenting in the largest public ED in Tanzania.