The incidence of malaria after splenectomy in Papua New Guinea

Abstract

The study was performed in East New Britain in the Bismarck Archipelago. Nonga Base Hospital, Rabaul, is the islands' referral hospital, and the plantations employ people from all over Papua New Guinea. In 1982-92, 115 patients were treated for splenic trauma, 31 by splenectomy and 84 by splenic conservation. Despite considerable effort, only 56 patients were traceable in 1993, largely because the others had moved to remote parts of Papua New Guinea (35 had returned to the Highlands, a non-malarious area). Six of the 56 had died; the causes of death could not be verified in the two who had undergone splenectomy, while relatives stated old age, bomb blast, cancer, and sorcery as causes in the four with conserved spleens. This left 50 patients (17 who had undergone splenectomy and 33 splenic conservation) who were followed up to obtain a history of post-trauma illnesses (malaria, upper respiratory tract infection, sores, influenza, tuberculosis) and to take blood for a full blood count and malarial film. We also studied 50 controls, similar in age, sex, and place of origin to the patients and admitted to the surgical wards during the same period for a non-traumatic cause. Data were analysed using the χ2 test.