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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2000  |  Volume : 11  |  Issue : 2  |  Page : 208-209
Urine Analysis in Malaria in Kassala Town, Eastern Sudan

Department of Pathology and Microbiology, University of Kassala, Sudan

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How to cite this article:
Karoum AO, Mohammed BA. Urine Analysis in Malaria in Kassala Town, Eastern Sudan. Saudi J Kidney Dis Transpl 2000;11:208-9

How to cite this URL:
Karoum AO, Mohammed BA. Urine Analysis in Malaria in Kassala Town, Eastern Sudan. Saudi J Kidney Dis Transpl [serial online] 2000 [cited 2019 Oct 18];11:208-9. Available from: http://www.sjkdt.org/text.asp?2000/11/2/208/36681
Malaria remains one of the major health problems in the tropics, including Sudan. In Sudan, [1] malaria was earlier confined to certain regions, but has now spread all over the country. [2] In Kassala State, Eastern Sudan, transmission occurs throughout the year. [3]

It is well known that the dominant species malaria parasite in Sudan is P. falciparum, and the presentation of the disease consists of fever, chills, sweat, generalized aches and pains, besides gastrointestinal distur­bances. Severe malaria may be complicated by cerebral involvement, shock syndrome, and acute renal failure. [4]

Intravascular hemolysis, which may occur in severe malaria, may lead to hemo­globinuria. Other renal complications in malaria include the nephrotic syndrome, which occurs in P. malarial infection, and acute glomerulonephritis reported with falci­parum malaria. [4] Proteinuria was reported in 20 to 80% of patient with malaria. [5]

In Sudan, including Kassala area, a febrile illness is generally considered malaria until proven otherwise. Fever, however, also marks other diseases, such as infections particularly of the urinary tract (UTI). We studied the urine constituents in patients suspected to have malaria, in an attempt to identify those patients with UTI with or without malaria.

The study was performed on 600 patients (300 female, 300 male) of different ages ranging from five to 70 years seen in Kassala Teaching Hospital, and the nearby clinics. These patients presented with a clinical picture suggestive of malaria. Peripheral blood smear was obtained from each patient to rule out/in malaria. From each patient we obtained a mid-stream urine specimen, which was examined for albumin using sulphasalicylic acid method. Urine specimens were centrifuged and then examined, using high power field, for pus cells, red blood cells and casts.

Out of the 600 patients examined for malaria, 465 (77.5%) showed positive blood film for malaria, while 135 (22.5%) were negative.

Urinary changes were seen in 430 out of 600 patients (71.7%). Of these 331 (71.2%) had positive blood film for malaria, and 99 (28.8%) had negative blood film. Albumi­nuria was found in 182 patients; 154 of them (84.6%) had positive blood film for malaria and 28 of them (15.4%) had negative blood film, (P < 0.001). Pyuria was seen in 143 patients (23.4%); 77 of them (53.8%) had positive film for malaria, and 66 of them (46.2%) had negative blood film for malaria (P not significant). Hematuria, which was microscopic in all cases, was detected in 64 patients (10.7%); 29 of them (45%) had positive blood film for malaria, and 35 of them (55%) had negative blood film for malaria. Granular casts were detected in 21 (3.5%) patients; 15 of them (71.4%) had positive blood film for malaria, and six (28.6%) had negative blood film for malaria. There was a combination of casturia, and albuminuria in four patients (0.7%), casturia and pyuria in seven patients (1.2%), and casturia and hematuria in one patient (0.2%). Our findings suggest that malaria may have a significant effect on the urine especially the presence of albuminuria and to a lesser extent microscopic hematuria and casturia and this can be confused with urinary tract infection. Urinalysis is not a diagnostic tool in identifying patients with malaria, but a significant number of patients with malaria may have proteinuria. It also appears that the presence of pyuria is not necessarily against the diagnosis of malaria.

   References Top

1.Goldsmith R, Goldsmith D. Tropical medi cine and parasitology, malaria. Prentice­Hall International Edition 1989;309-ll.  Back to cited text no. 1    
2.Bayomi A. The history of Sudan Health Services. 1979;259.  Back to cited text no. 2    
3.Annual report of the information centre, (1996-98), Kassala State Ministry of Health.  Back to cited text no. 3    
4.Trenold E. Muirs text book of pathology, pathology of malaria, (ELBS). 1992; 13: 1144-48.  Back to cited text no. 4    
5.Wernsdorfer WH, et al. Principal and practical of malariology, first edition Churchill Livingstone, kidney involve ment in malaria. 1988;652-57:721-3.  Back to cited text no. 5    

Correspondence Address:
Abu El Gasim Osman Karoum
Department of Pathology and Microbiology, University of Kassala
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PMID: 18209317

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