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He was transferred to the district hospital for further investigations after transfusion of three units of blood. Unfortunately, he self-discharged without receiving appropriate investigations and medical treatment. Subsequently, his family sought help from the local traditional healer who performed scarification to attempt to treat him. Further efforts to emphasise the importance of hospital-based care proved unsuccessful, and sadly this man died at his family home 3\u2005months after his initial presentation.<\/jats:p>","DOI":"10.1136\/bcr-2013-202844","type":"journal-article","created":{"date-parts":[[2014,7,4]],"date-time":"2014-07-04T06:48:18Z","timestamp":1404456498000},"page":"bcr2013202844","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Massive splenomegaly in rural Malawi: new wine, old wineskins and the importance of collaboration"],"prefix":"10.1136","volume":"2014","author":[{"given":"Navin","family":"Venkatraman","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine, University Hospitals of Leicester, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"White","sequence":"additional","affiliation":[{"name":"Nottinghamshire Healthcare NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Haensel","sequence":"additional","affiliation":[{"name":"Northamptonshire Healthcare Foundation Trust, Northampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,7,4]]},"reference":[{"key":"2025082701452933000_2014.jul04_1.bcr2013202844.1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.11-5-456"},{"key":"2025082701452933000_2014.jul04_1.bcr2013202844.2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001149"},{"key":"2025082701452933000_2014.jul04_1.bcr2013202844.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09680-0"},{"key":"2025082701452933000_2014.jul04_1.bcr2013202844.4","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(80)90019-X"},{"key":"2025082701452933000_2014.jul04_1.bcr2013202844.5","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(68)90124-7"},{"key":"2025082701452933000_2014.jul04_1.bcr2013202844.6","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S0308-2261(21)00307-6","article-title":"Tropical splenomegaly. 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