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close this bookManagement of Severe and Complicated Malaria - A Practical Handbook (WHO - OMS, 2000, 69 p.)
View the document(introduction...)
View the documentPreface
View the documentIntroduction
View the documentSevere and complicated malaria
Open this folder and view contentsGeneral management
Open this folder and view contentsSalient clinical features and management of complications
Open this folder and view contentsSpecial clinical features of severe malaria and management of common complications in children
Open this folder and view contentsSpecial clinical features and management of severe malaria in pregnancy
Open this folder and view contentsDiagnosis of malaria
View the documentPrognostic indicators
View the documentCommon errors in diagnosis and management
View the documentSelected further reading
View the documentAnnex 1. Notes on antimalarial drugs
View the documentAnnex 2. The Glasgow coma scale
View the documentAnnex 3. Measurement of central venous pressure
View the documentBack cover

Common errors in diagnosis and management

The common errors in the diagnosis and management of severe malaria are listed below.

Errors in diagnosis

Failure to do a malarial blood film
Failure to take a travel history
Misjudgement of severity
Faulty parasitological diagnosis and laboratory management
Failure to diagnose other associated infections
Missed hypoglycaemia
Failure to carry out an ophthalmoscopic examination for the presence of retinal haemorrhages
Misdiagnosis (e.g. influenza, viral encephalitis, hepatitis, scrub typhus, etc.)

Errors in management

Inadequate nursing care
Errors of fluid and electrolyte replacement
Delay in starting antimalarial therapy
Use of an inappropriate drug (e.g. chloroquine in areas of resistance)
Unjustified withholding of an antimalarial drug
Dosage not correctly calculated
Inappropriate route of administration (see front cover flap)
Failure to elicit a history of recent chemotherapy
Unjustified cessation of treatment
Failure to control the rate of intravenous infusion
Failure to prevent cumulative effects of antimalarial drugs
Failure to switch patients from parenteral to oral therapy as soon as they can take oral medication
Unnecessary continuation of chemotherapy beyond the recommended length of treatment (see front cover flap)
Unnecessary endotracheal intubation
Failure to prevent or control convulsions
Failure to recognize and treat severe anaemia
Use of potentially dangerous ancillary therapies
Delay in considering obstetrical intervention in late pregnancy
Failure to recognize and manage pulmonary oedema, aspiration pneumonia, and metabolic acidosis
Delay in starting peritoneal dialysis or haemodialysis
Failure to review antimalarial treatment in a patient whose condition is deteriorating