Clinical Manifestations, Treatment, and Outcome of Hospitalized Patients with Plasmodium vivax Malaria in Two Indian States: A Retrospective Study

Jagjit Singh,Nilima Kshirsagar,Bhargav Purohit,Anupama Desai,Lalita Savardekar,Preeti Shanbag

doi:10.1155/2013/341862

Abstract

This was a retrospective study done on 110 patients hospitalized with P. vivax malaria in three medical college hospitals, one in the union territory of Chandigarh and the other two in Gujarat, that is, Ahmedabad and Surat. The clinical presentation, treatment, and outcome were recorded. As per WHO criteria for severity, 19 of 110 patients had severe disease—six patients had clinical jaundice with hepatic dysfunction, three patients had severe anemia, three had spontaneous bleeding, two had acute respiratory distress syndrome, and one had cerebral malaria, hyperparasitemia, renal failure, circulatory collapse, and metabolic acidosis. All patients with severe P. vivax malaria survived, but one child with cerebral malaria had neurological sequelae. There was wide variation in the antimalarial treatment received at the three centres. Plasmodium vivax malaria can no longer be considered a benign condition. WHO guidelines for treatment of P. vivax malaria need to be reinforced.

Highlights

India accounts for 77% of the total malaria in south-eastAsia with Plasmodium vivax being responsible for more than50% of the cases
India which describe the whole spectrum of severe clinical manifestations of P. vivax malaria [2,3,4]
The WHO guidelines for the treatment of malaria recommend chloroquine as first-line treatment for uncomplicated P. vivax malaria with 14 days of primaquine for radical cure

Summary

Introduction

India which describe the whole spectrum of severe clinical manifestations of P. vivax malaria [2,3,4]. Malaria case management remains a vital component of malaria control strategies. The WHO guidelines for the treatment of malaria recommend chloroquine (except in areas of chloroquine resistance) as first-line treatment for uncomplicated P. vivax malaria with 14 days of primaquine for radical cure. The WHO guidelines for the treatment of malaria recommend that intravenous artesunate should be used for the treatment of severe malaria (falciparum and vivax) for a minimum period of 24 hours. The present study was done to evaluate the clinical manifestations and outcome in patients hospitalized with P. vivax malaria and whether WHO guidelines for treatment of P. vivax malaria were being adhered to

Methods

Results

Discussion