Clinical and Epidemiological Profiles of Severe Malaria in Children from Delhi, India

Kaushik, Jaya Shankar; Gomber, Sunil; Dewan, Pooja

doi:10.3329/jhpn.v30i1.11291

Cited by 32 publications

(36 citation statements)

References 6 publications

(8 reference statements)

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“…This number is 3.6% of the total children, and 10.5% of the children with severe malaria. This is comparable to 13.85% in the study from Bikaner [11] but way less than 50% as reported from Delhi [18] .There was no death with cerebral malaria in our study. Similar results have been seen in other studies in which all the patients recovered completely without any neurological sequelae [11,18] .…”

Section: Discussionsupporting

confidence: 73%

Changing trends in the clinical and hematological profile of Plasmodium vivax mono infection

Uppal¹,

P²,

Singh³

et al. 2017

Int. J. Curr. Res. Med. Sci.

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Background: Malaria continues to be a major public health problem in South East Asia. Plasmodium vivax is the most widely distributed human malaria parasite with an at-risk population of 2.5 billion persons. With the implementation of molecular diagnosis, it has become evident that P.vivax mono infection could also result in multiple organ dysfunction and severe life-threatening disease as seen in P. falciparum infection. Objectives: To study the changing trends in the clinical and hematological presentation of the Plasmodium vivax malaria and to sensitize the health care provider about the changing presentation of the Plasmodium vivax mono infection and to introduce a high index of suspicion against it's potentially life threatening complications hitherto considered not significantly prevalent, by printing and publishing the data thus obtained and circulating it amongst the health care providers in and around Amritsar. Methods: This is a single center prospective study including 100 children attending thalassemia day care center and on regular blood transfusion therapy for a minimum of 2 years and whose ferritin level is above 1000 μgm/dl. Detailed history and examination were recorded in the proforma. Blood was drawn for thyroid function tests and most recent ferritin value obtained from patients record was used for analysis. Results: A total of 55 cases of vivax malaria were included in the study. Severe disease was present in 19(34.5%) cases of malaria. In addition to fever, the most common clinical features at presentation in children were: fatigue in 96.4%(53/55), headache in 54% (30/55), myalgia in 54%(30/55), arthralgia in 43%(24/55), vomiting in 64% (35/55) and nausea in 58%(32/55).Hepatosplenomegaly in 51% (28/55) of patients, splenomegaly in 26% (14/55) and hepatomegaly alone in 3% (2/55), varying degrees of icterus in 20% (11/55) and respiratory distress in 12.7% (7/55). Anemia was present in 89.1% (49/55) and thrombocytopenia (platelet count < 1,50,000/μL) was present in 45.5% (25/55) of the children.

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Section: Discussionsupporting

confidence: 73%

Changing trends in the clinical and hematological profile of Plasmodium vivax mono infection

Uppal¹,

P²,

Singh³

et al. 2017

Int. J. Curr. Res. Med. Sci.

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“…In general, severely ill patients with a diagnosis of P. falciparum infection came with the same syndromes but were more likely to present two or more of these. Table 7 details findings from prospective hospital-based studies (130)(131)(132)(133)(134)(135). The authors of these reports set out to systematically classify patients upon admission to hospital with a primary diagnosis of malaria and to longitudinally collect substantial numbers of patients.…”

Section: Retrospective Hospital-based Studiesmentioning

confidence: 99%

Evidence and Implications of Mortality Associated with Acute Plasmodium vivax Malaria

2013

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SUMMARYVivax malaria threatens patients despite relatively low-grade parasitemias in peripheral blood. The tenet of death as a rare outcome, derived from antiquated and flawed clinical classifications, disregarded key clinical evidence, including (i) high rates of mortality in neurosyphilis patients treated with vivax malaria; (ii) significant mortality from zones of endemicity; and (iii) the physiological threat inherent in repeated, very severe paroxysms in any patient, healthy or otherwise. The very well-documented course of this infection, with the exception of parasitemia, carries all of the attributes of “perniciousness” historically linked to falciparum malaria, including severe disease and fatal outcomes. A systematic analysis of the parasite biomass in severely ill patients that includes blood, marrow, and spleen may ultimately explain this historic misunderstanding. Regardless of how this parasite is pernicious, recent data demonstrate that the infection comes with a significant burden of morbidity and associated mortality. The extraordinary burden of malaria is not heavily weighted upon any single continent by a single species of parasite—it is a complex problem for the entire endemic world, and both species are of fundamental importance. Humanity must rally substantial resources, intellect, and energy to counter this daunting but profound threat.

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“…The literature proposes clinical immunity to malaria in low-transmission settings to be one of the reasons for this phenomenon [9]. The Colombian literature reports that 17 % of the patients have presented multiple malaria episodes [8, 10]. Although this study aimed to describe this situation, the medical records reviewed did not have sufficient data, 43/60 cases and 76/120 of the controls did not have information available, which is the reason why this variable was not included in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the severity and complication of patients with malaria hospitalized between 2009 and 2013 in three municipalities of Colombia, case control study

Ramirez

Porras

Borrero

et al. 2016

Malar J

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BackgroundMalaria worldwide annual reported cases range between 250 and 500 million and nearly half a million deaths are reported every year. Colombia has a vast expanse of territory with environmental and social conditions conducive to malaria transmission, which is the reason why it has second place in Latin America for the number of cases of malaria.MethodsThis is a retrospective, paired, case–control study that compares patients with severe malaria and malaria patients without mention of complication. Medical records of patients with confirmed malaria diagnosis were reviewed. The objective of this study was to identify factors associated with complicated malaria in three municipalities of Colombia during the period 2009–2013.ResultsA total sample of 180 medical records was collected, 60 corresponding to cases and 120 to controls following a 1:2 ratio. From the total sample, 88.33 % (159) of subjects were originally from Tumaco, 7.78 %, most of the patients of the study (104) were diagnosed and treated in 2013. Among the laboratory findings, the platelet count was found to have statistically significant differences between cases and controls; this was also true for total bilirubin value and transaminases. The most prevalent severity finding was clinical jaundice, followed by elevated bilirubin (25 %) and elevated transaminases (44.4 %). Thrombocytopenia was found in 11/44 cases (20 %) and only five of 60 patients (8.3 %) presented severe anaemia. The multivariate analysis showed that a platelet count <100,000 and clinical jaundice not associated with organ failure, were the two variables associated with severe malaria in the patients described.ConclusionsMost of the cases studied, despite meeting criteria of severity, were shown not to be as morbid or severe as in other countries. Clinical jaundice and thrombocytopaenia are associated with severe malaria, and they can be used by general practitioners or primary care physicians to promptly identify patients who may have severe malaria.

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Clinical and Epidemiological Profiles of Severe Malaria in Children from Delhi, India

Cited by 32 publications

References 6 publications

Changing trends in the clinical and hematological profile of Plasmodium vivax mono infection

Changing trends in the clinical and hematological profile of Plasmodium vivax mono infection

Evidence and Implications of Mortality Associated with Acute Plasmodium vivax Malaria

Factors associated with the severity and complication of patients with malaria hospitalized between 2009 and 2013 in three municipalities of Colombia, case control study

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