CONVULSIONS IN CHILDHOOD MALARIA

A retrospective survey was conducted of all 2911 children admitted wit h malaria to 4 provincial hospitals in eastern Thailand between 1977 a nd 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 cons cious and had no fits (5 died). Thus the relative risk of a fatal outc ome associated with convulsions, in the absence of cerebral malaria, w as 92 (95% confidence interval [CI] =2.5-34.1), P=0.004. Overall, Plas modium falciparum caused 81% of infections, P. vivax 16%, and 3% were mixed. Convulsions without cerebral malaria were more common in childr en 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 fal ciparum malaria (8.3%) compared with vivax malaria (4.7%): relative ri sk 1.7 (95% CI=1 1-2.7). Convulsions are an important complication of malaria in young children, and are associated specifically with P. fal ciparum infection, even in otherwise uncomplicated malaria.