Hyperreactive Malarial Splenomegaly (HMS) in Malaria Endemic Area in Eastern Sudan

Abstract

Hyrerreactive Malarial Splenomegaly (HMS) is a condition affecting adults in certain malarious areas. The present work was carried out in Kassala city, Eastern Sudan where HMS is considered as highly prevalent. The objectives of the study were to describe the epidemiology and magnitude of the disease in the area, help local clinicians to diagnose, and differentiate HMS cases from other diseases causing splenomegaly and to apply modern investigative methods particularly Nested Polymerase Chain Reaction (PCR) for detection of malaria parasites in HMS cases. A cross-sectional study was carried out in four health centers in the city between January and March 2004. 114 (11.2%) out of 1010 medical cases were reported had enlarge spleens. Identification using the major diagnostic criteria supported by clinical and laboratories investigations was revealed that 87 (8.6%) cases were HMS. All the cases included in this study are permanent residents of Kassala city. Forty one percent patients are Beni Amer, 25% Shaikia, 19.5% Hadendoa and 14% are from other tribes. Sixty three percent of HMS cases were males and 37% were females. The mean age of 27.7 years (median= 25 years). Clinical investigations showed that all cases suffered from abdominal pain in upper left quadrant and all had palpable firm spleen (10-26 cm) from the costal margin. Most of cases gave a past history fever associated with headache. The mean value of body temperature of all studied patients is in normal range (37ºC).