Clinical manifestations of severe forms of P. falciparum malaria in koraput district of Orissa State, India.

The Orissa state on the east coast of India is endemic for malaria for decades1. The state with a population of 3.6%, contributes about 22% of all malaria cases, 43% of the Plasmodium falciparum cases and 33% of total malaria related deaths in the country. Out of 30 districts in Orissa 27 are endemic for malaria and the average annual parasite incidence (API) for the state is 18.6 (+ 13.7). The Koraput district (17o50’N and 20o30’N, 81o27’ and 84o10’E) has an average API of 20.3. Transmission of malaria is perennial in all hilltop and foothill villages2. Since malaria remains a major killer disease in this area, there is a need to understand the progress of clinical manifestations of the disease from acute stage to complications and to determine a clinical stage where the patients enter clinical severity so that an early warning system can be developed to prevent serious morbidity and mortality due to malaria. Therefore, a situation analysis has been carried out to know the spectrum of severe and complicated forms of falciparum malaria in this district.