Malaria Control & Elimination

Management Malaria with Jaundice

Abstract

Made Susila Utama* and Tuti Parwati Merati

Malaria is the most important parasitic disease in the world related to high morbidity and mortality. Jaundice is one of the common manifestation of severe malaria in adults and its incidence vary from 10-45% in different regions. Presence of jaundice in malaria indicates a more severe illness with higher incidence of complication. Jaundice plus evidence of other vital organ dysfunction vital as one of manifestation of severe malaria based on WHO guideline 2010. Jaundice in severe malaria caused by multi factorial and can result from haemolysis of parasitized and nonparasitized red blood cell, hepatic dysfunction and possibly an element of microangiopathic haemolysis associated with disseminated intravascular coagulation. Awareness of malaria biliosa is important to prevent complication and mortality. Death from severe malaria often occurs within hours of admission to hospital or clinic, so it is essential that therapeutic concentrations of a highly effective antimalarial are achieved as soon as possible. Management of severe malaria comprises four main areas: clinical assessment of the patient, specific antimalarial treatment, adjunctive therapy and supportive care. Many trials are consistent and suggest that artesunate is the treatment of choice for adults with severe malaria. Management of malaria biliosa is not different from management the other severe malaria. Here we report one case of jaundice in falciparum malaria (malaria biliosa). There was problematic in management but the treatment malaria with jaundice with adequate dose of artesunate injection improved patient’s health status and parasitological improvement.