4. A STUDY OF SPECTRUM OF MALARIA WITH SPECIFIC REFERENCE TO PLASMODIUM VIVAX

Naresh Kr Midha, Chhabra V, Sharma R, Chaudhary M, Mahavar S

ABSTRACT

BACKGROUND: Malaria is one of the most common infectious diseases and a great public health problem worldwide, particularly in Africa and south Asia. P.falciparum is well known for severe complicated malaria while P. vivax malaria (benign tertian malaria) so far, was considered to have a benign course that causes disease resulting in lower case-fatality rates. Plasmodium vivax is now recognized as a cause of severe and fatal malaria. In this study the clinical profile of patients with malaria with regards to demographic, clinical and biochemical profile and its complications was done with specific reference to vivax malaria. AIMS AND OBJECTIVES: The aim of our study was to present the clinical features, hematological and biochemical profile of malaria with specific reference to Plasmodium vivax and to present the comparative study of complications and outcome of P. vivax, P.falciparum and mixed infection (vivax + falciparum). MATERIALS AND METHODS: This was a prospective observational study done at a tertiary care hospital in Jaipur over 12 Months period. All diagnosed cases of malaria, including P.vivax, P.falciparum and mixed infections were studied and their demographic profile, complications and course of disease were noted. Data was analyzed using appropriate statistical tests. RESULTS: 210 cases of malaria were included in the study and out of them 120 were infected with P.vivax and 63 with P. falciparum. Severe disease was present in 18 (15%) cases of vivax malaria and 33 cases (52%) of falciparum malaria. A mixed infection was found in 27 cases and out of them 14 were of severe category (52%). The complications seen in vivax malaria were: thrombocytopenia (75.7%), ARDS (1.61%), malarial hepatitis (14.28%), acute renal failure (13.8%), cerebral malaria (11%) and the mortality in vivax and falciparum malaria cases was 1.75% and 3.64% respectively. CONCLUSIONS: Plasmodium vivax is a cause of severe and fatal malaria despite its low parasite biomass. The incidence of ARDS, thrombocytopenia, leukocytopenia, in P.vivax malaria was as higher as compared to P.falciparum or mixed infection, while renal, hepatic, lung and cerebral involvement were seen with increasing frequency in falciparum malaria and mixed malaria cases.

Key-words: Fever, Malaria, Plasmodium vivax, Thrombocytopenia.

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