Changing Profile of Severe Malaria in North Indian Children

Abstract

Severe and fatal vivax malaria is an emerging recognized entity and challenges the perception of Pv as a benign disease. Further clinical studies and molecular research is required to understand emergence of severe malaria in vivax mono-infection.

Clinical spectrum and treatment outcome of severe malaria caused byPlasmodium vivaxin 18 children from northern India

“…3 In another study from Delhi, it was observed that severe anaemia, cerebral malaria, and shock were more frequent among children infected with P. falciparum. 4 These results were consistent with our findings of severe anaemia among P. falciparum group. In addition, there are a number of case series and retrospective data on severe vivax malaria among adults and children that have been reported from other parts of North India.…”

“…A recent study by Yadav et al 4 reported thrombocytopenia in 83.2% cases with P. vivax malaria, however severe thrombocytopenia requiring platelet transfusion was seen in only 13%. In contrast, our study saw 50% (9/ 18) of the P. vivax severe malaria cases having low platelet count, of whom three (16.7%) had profuse bleeding requiring platelet transfusion.…”

“…P. vivax is increasingly recognized as an important cause of severe malaria in children with clinical manifestations like cerebral malaria, anaemia, and thrombocytopenia. [1][2][3][4] In a large prospective study from Bikaner district of North India, 150 children admitted with severe malaria were analyzed, and it was observed that P. vivax monoinfection contributed to one third of cases. 3 It was also seen that children under 5 years infected with P. vivax infection had higher risk of developing severe malaria when compared to those infected with P. falciparum [OR 2.3 (1.4-3.76)].…”

“…Recently, P. vivax is being increasingly recognized as one of the etiological factors for severe malaria in children and adults. [1][2][3][4] The clinical presentation of severe malaria caused by P. falciparum and P. vivax were similar among children from Papau New Guinea except for higher chances of respiratory distress among the latter. 1 In a large prospective study from Bikaner district of North India, it was found that a proportion of under five children infected with P. vivax had a greater propensity for development of complications including severe anaemia, thrombocytopenia, cerebral malaria, acute respiratory distress syndrome, hepatic dysfunction, renal dysfunction, and abnormal bleeding.…”

“…3 Similar observations were generated in another study from Delhi where children with severe malaria infected with P.vivax had more hepatic, renal, respiratory, and bleeding complications with less overall mortality when compared to falciparum malaria. 4 P.vivax is being increasingly recognized as a causative agent of severe malaria from North India. Hence the present study was undertaken to outline the clinical profile and outcome of children with severe vivax malaria admitted to a tertiary hospital in Rohtak.…”