STUDY OF ABNORMAL FINDINGS ON DIPSTICK URINE ANALYSIS IN PATIENTS WITH MALARIA IN A TERTIARY CARE HOSPITAL OF ODISHA

Dr Chandra Sekhar Mohapatra

Volume : IX, Issue : II, February - 2019

STUDY OF ABNORMAL FINDINGS ON DIPSTICK URINE ANALYSIS IN PATIENTS WITH MALARIA IN A TERTIARY CARE HOSPITAL OF ODISHA

Dr Chandra Sekhar Mohapatra

Abstract :

Background: In India Malaria is still a major health problem with many challenges.Early detection of the disease and its complication remains the key for reducing morbidity and mortality.Urine analysis is a cheap and easy but very valuable method for diagnosis of many diseases and conditions.Studies on urinalysis for abnormalities in malaria patients are limited and the extent to which abnormalities do appear in urine of the patients in this malaria–endemic area needs to be studied.Inorder to minimise the mortality and morbidity of malaria,accurate diagnosis and proper management are very essential. Therefore it is imperative to determine changes in urinary composition and its relationship with diagnosis and prognosis of malaria.We determined urinary abnormalities in malaria patients.The objectives of the study are (1)To document most common abnormalities in urine in patients with malaria infection and (2)To find out urinary changes which may help in predicting the diagnosis and prognosis of malaria. Materials and methods:The study was carried out at Sri Ram Chandra Bhanja(SCB) Medical College and Hospital,Cuttack,Odisha from July 2016 to December 2016 during the period in which malaria transmission is usually at its peak.A total of 110 participants comprising 55 patients of confirmed malaria cases and 55 healthy individuals as controls of same age and sex were investigated.Blood was collected for routine and rapid diagnostic test (RDT) and both thick and thin smears prepared for confirmation of malaria parasites microscopically.Urine was collected and analysis was performed with Dipstick Urinalysis strips and various biochemical components were measured using automated urine analyzer and findings were analyzed.The demographic and clinical data were recorded with a set of questionnaire. Results: Out of 296 fever cases of clinically suspected malaria only 55 cases were found microscopically confirmed malaria cases showing incidence of malaria is 18.6% among clinically suspected. In the study it was observed that all the urinary parameters were elevated in malaria cases when compared with controls. Proteinuria was found in 76.4%,Urobilinogenuria in 65.5%,Bilirubinuria in 41.8% and hematuria was detected in 40% of malaria cases. Urine protein(P<0.001),urobilinogen(P<0.001),Bilirubin(P<0.001) and RBCs(P=0.001) were significantly higher in patients with P.falciparum infection when compared with p.vivax infection. Conclusion: In malaria infection there is significant changes in chemical composition of urine.The most frequent abnormalities in the urinalysis were proteinuria,increased specific gravity,urobilinuria and bilirubinuria which can be easily detected by simple Dipstick urinalysis.Eventhough urinalysis is not an alternative tool for malaria diagnosis this can be used together with light microscopy in resource–limited endemic areas for corroborating the diagnosis and finding signs of complications of malaria.