Clinical profile and complications of acute malaria caused by different species of Plasmodium

Abstract

Introduction: Malaria is more severe in children than in adults and 78% of all deaths due to malaria occur in children under 5years. Plasmodium vivax has long been considered to have benign course. However during past few years several studies reported severe complicated cases of vivax malaria. Methodology: Children in the age group of 6 months to 15 years admitted in the Department of Pediatrics with clinical malaria were tested for malaria using peripheral smear, QBC and rapid diagnostic test. Children with positivity of any of these tests were enrolled in the study. Complete clinical profile is noted. Investigations like complete blood counts, LFT, RFT etc., were done. Results: Out of 150 children enrolled in the study 80 had Plasmodium vivax monoinfection. 61 had Plasmodium falciparum monoinfection and 9 had mixed infection. 41% of them were under 5years of age. The incidence of complications like severe anemia (10% vs. 18%), jaundice (10% vs. 44%), transaminitis (6% vs.13%), azotemia (6% vs. 36%) and thrombocytopenia (12.5% vs. 26%) were more common in P falciparum than in P vivax malaria with statistical significance (p < 0.05). There was no statistically significant difference in the incidence of hypoglycemia and cerebral malaria in P vivax and P falciparum malaria. Conclusion: The incidence of severe malaria in P. vivax infection is comparable to that in P. falciparum infection and it is no more benign. Hence robust efforts are required for reduction and elimination of P vivax transmission.