HEPATOMEGALY IN ACUTE FALCIPARUM-MALARIA IN CHILDREN

The characteristics of hepatomegaly in acute falciparum malaria were s tudied in 114 children presenting consecutively with the disease. Hepa tomegaly was more common than splenomegaly and was significantly more frequent in younger than in older children. In children with hepatomeg aly at presentation, there was an equal sex distribution, a negative c orrelation between liver size and age, and a positive correlation betw een liver enlargement and the reported duration of symptoms at present ation. Symptoms attributable directly to liver involvement were relati vely uncommon. There was no correlation between liver and spleen size, presenting core temperature, or peripheral parasite density. Tender h epatomegaly and tender splenomegaly were rare during the acute illness ; tenderness resolved within 72 h after commencement of antimalarial t herapy. Complete resolution of hepatomegaly occurred in 41% of childre n after recovery from the acute illness (by days 7 or 14), varying deg rees of resolution occurred in 48% and no reduction or an increase in liver size occurred in the remainder. In children with hepatomegaly wh o failed to clear parasitaemia by days 7 or 14, persistent hepatomegal y was common. These results suggest that hepatomegaly, like splenomega ly, may be assessed as a possible malariometric index of the intensity of transmission in children in an endemic area.