A study of clinical profile of malaria with special reference to complications and outcome

Abstract

Background: Malaria has a wide clinical spectrum ranging from uncomplicated disease to a fatal one. The objectives were to study clinical profile of Malaria with special reference to its complications and outcome.Methods: A prospective observational study was done in a tertiary care hospital including total of 300 patients diagnosed with Vivax or Falciparum Malaria. Data on patients’ clinical details with investigations, complications, and outcome was recorded and analysed using SPSS version 17.Results: Out of 300 patients, 179 had Vivax and 121 had Falciparum Malaria. Oliguria, high coloured urine, altered sensorium, convulsion, breathlessness, bleeding was more common in Falciparum malaria. Hypoglycaemia, thrombocytopenia, renal and hepatic involvement and ALI/ARDS were also more common in falciparum group. However, ALI/ARDS was more fatal in vivax group. Complications, outcome and biochemical parameters were correlated with parasite index and the correlations were statistically significant. Out of 22 deaths, 12 patients were from falciparum and 10 were from vivax group. Most common complication leading to death was ARDS/ALI, followed by AKI, convulsion, hepatic involvement and bleeding in decreasing order in both types of Malaria. Three patients with parasitic index <5% and 19 patients with parasitic index >5% died.Conclusions: Clinical profile of Falciparum Malaria was more complicated. Metabolic complications with multi organ involvement, ALI/ARDS and mortality were more in Falciparum Malaria. Correlation of parasitic index with complications, biochemical parameters and outcome in both the groups was statistically significant.