Risk of malaria among febrile patients: retrospective analysis of a hospital-based study in an endemic area of northeast India

Abstract

Febrile illness is the most common symptom experienced by patients suspected of having malaria, especially in the malaria endemic areas of northeast India. Hospital-based data from two districts of upper Assam, namely Golaghat and Tinsukia, were analysed to assess the prevalence of malaria among inpatients who reported to health centres with febrile illness. A total of 16 hospitals were selected for the study. These included six government hospitals (three in rural and three in urban areas) and 10 private hospitals, which included four tea-garden hospitals. Selection was dependant on the availability of patients and inpatient treatment facilities. During the study, a total of 350 inpatients reported to the selected hospitals with fever; 324 were suspected of having malaria and were interviewed and included in the study. The average age of patients was 24.2±15.2 years and 63.3% (205/324) of them were male. The majority of patients (77.5%; 251/324) belonged to the lower household income category (<5000 Indian rupees) and travelled to the nearest town or city for treatment. Overall, the prevalence of malaria (as diagnosed by clinical examination and blood tests) across the different categories such as location, types of hospitals and household income was found to be 29.9% (97/324). Multivariate analysis revealed that the adjusted odds ratios (AOR) of malaria cases was higher based on location (2.13), type of health centre (1.75) and the distance travelled to a health centre (2.09). The mean duration of hospital treatment was 4.2±3.6 days and the delay in reporting to hospital was 3.9±2.6 days. The study emphasises the need to strengthen and improve the treatment facilities for malaria in government hospitals, and to create more awareness among people regarding early treatment, especially in the rural periphery villages of the endemic areas.