UPSURGE OF MALARIA-RELATED CONVULSIONS IN A PEDIATRIC EMERGENCY ROOM IN NIGERIA - CONSEQUENCE OF EMERGENCE OF CHLOROQUINE-RESISTANT PLASMODIUM-FALCIPARUM

From January through December 1988 the causative factor of each case o f childhood seizure seen in the Children's Emergency Room of the Unive rsity of Calabar Teaching Hospital, Calabar, Nigeria, was prospectivel y studied with a focus on the relative importance of malaria-related s eizures. Of the 134 seizure cases seen, febrile convulsion (FC) formed the majority (55%) with cerebral malaria (CM) as the only major (33%) rival. Other conditions such as meningitis, epilepsy, hypoglycaemia a nd drug poisoning together (12%) played a minor role. Malaria was the dominant cause (73%) of FC; 81% of these cases did not respond to chlo roquine. On comparing the number of cases of CM accumulated in the sam e unit from 1986, there was a significant increase (P<0.001) in the pr oportion of yearly CM admissions from 1986 through 1988. The study con firms the premier position of malaria in the causation of childhood se izures and also suggests a possible upsurge in the prevalence of CM in the environment. This upsurge probably derives from the emergence of chloroquine-resistant Plasmodium falciparum (CRPF) reported in Nigeria which appeared to have been identified in the present study. While mo re studies are needed to confirm this hypothesis, clinicians in areas of CRPF are alerted about a Possible upsurge in CM in their locality.