الفهرس 
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Abstract
Summary
Malaria is an acute systemic illness caused by infection with Plasmodium,
all of which are transmitted to humans by female Anopheles species mosquitoes.
The majority of the infections and deaths are caused by P. falciparum infection of
children. In fact, P. falciparum is responsible for more deaths in children less than
5 years of age than any other single infectious agent.
Our study had been carried out in El Fasher town the capital of the northern
state of Darfur. The main causative agent in our area of study was Plasmodium
falciparum (85% to 95%). Malaria transmission parameters vary according to the
vectors, water sources and populations present in each specific location.
Predominant malaria vector in Darfur was Anopheles arabiensis. The humidity
increases towards the Western and Southern areas of the region. The timing of the
rain season in the Darfur region begins in May, peaks in July-August and finishes
in October. Darfur population travels from areas of low transmission to an area of
higher transmission due to their crisis will be most susceptible to severe malaria
due to their low immunity.
The current study had started from the 2nd day of May till the end of August
2009. The aim of this work was to study malaria disease among people presented
to outpatient clinic of the Egyptian ministry of defense and El Fasher educational
hospital.
All patients had been subjected to full medical history taking including age,
clinical evaluation for fever, complete clinical examination and evaluation for
severe clinical malaria manifestations, all patients had been subjected to following
laboratory procedures: blood film, paracheck, complete blood count, liver
biochemical profile and kidney profile.
All patients were admitted to the hospital to receive treatment according to
the protocol of treatment which was approved by Ministry of Health in Sudan.
The results showed that 63% of patients were male, all patients (100%) had
a fever as presenting symptom, the majority of patients experience sweating
(100%), rigors and chills (71%), myalgia, headache and fatigue (86%), the
patients with dark color of urine (15%) had disturbed liver profile. Patients with
loss of appetite were 11%, nine of them were less than 5 years; it represent about
23% of patients less of 5 years old, The results showed that fourteen patients
(14%) had taken preventive antimalarial drugs.
Summary
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Many complications had happened like cerebral malaria, renal failure, anemia,
liver dysfunction and post neurological malaria syndrome.
The result showed that ninety one patients were positive by rapid diagnostic tests.
RDTs used in the study based on antibody method which was not specific.
Travellers and their doctors should be aware that no antimalarial prophylactic
regimen gives complete protection, but good chemoprophylaxis reduces the risk of
fatal disease. All the malaria drugs had been manufactured in different countries.
About 90% of malaria drugs in Sudan had been imported from China, India, and
other countries from south est. Asia. Drugs from Europe were very expensive, so
it wasn’t available. We hadn’t given patient treatment according the protocol. We
had given treatment according to what was available.
Thirty one (31%) patients had received Art + Fansidar, twenty nine patients (29%)
had received Art + Lumfantrine, five patients (5%) had received Art +
doxycycline, five patients (5%) had received Ast + meflquine, eleven patients
(11%) had received Art IM, nine patients (9%) had received Kinine and ten
patients (10%) had received Kinine + Doxy.
Patients with uncomplicated Plasmodium falciparum malaria were treated with an
artemisinin-based combination therapy (ACT) according to World Health
Organization (WHO) guidelines, in our study we had used mainly
artsunate+fansidar and art +lumfanrine; both were 60%.
The patients had been discharged from hospital after their clinical condition had
been improved, we couldn’t follow up all Sudanese patients. We had followed up
all the Egyptian patients.
Malaria remains one of the major killers of the human population, threatening
lives of more than one third of the world’s population. Despite tremendous
improvement in control measures in the last decade, malaria still remains a major
public health problem in the world, 216 millions of malaria cases reported in the
world in 2010. According to World Health Organization (WHO) global
estimations in 2010, 655.000 deaths occurred and 86% of them among children
less than five years old.
Severe malaria is a medical emergency. After rapid clinical assessment and
confirmation of the diagnosis, full doses of parenteral antimalarial treatment
should be started without delay with any effective antimalarial first available.