Clinical Profile of Malaria With Special Reference to Hematological and Renal Alterations

Abstract

Hematological and Renal alterations are seen mostly in Plasmodium falciparum infection, but P.vivax can occasionally contribute for renal, hematological impairment. Malarial ARF, Anemia, thrombocytopenia is commonly found in nonimmune adults and older children with malaria. Occurrence of ARF, jaundice, anemia in severe malaria is quite common in Southeast Asia and Indian subcontinent. Several hypotheses including mechanical obstruction by infected erythrocytes, immune mediated glomerular and tubular pathology, and alterations in the renal microcirculation, lead to renal failure. METHODOLOGY: 220 patients were included in the study who are positive for malarial antigen and routine laboratory tests were like CBC, liver function tests, renal profile, peripheral smear were done at Basaveshwar Teaching and General Hospital, attached to Mahadevappa Rampure Medical College. RESULTS: 220 patients of malaria were analyzed. 60% had Plasmodium vivax, 34% had Plasmodium Falciparum and 6% had mixed infection. Complications of Plasmodium falciparum-Jaundice 47.5%, Anemia 27.5%, Renal failure 25%, Cerebral malaria 15%, ARDS 2.5%,Thrombocytopenia 5% and Hypoglycemia 5%.Complications of Plasmodium vivax-Jaundice 1.5%, Anemia 5.3%, Renal failure 6%. Cerebral malaria occurred in 2.7% of cases. Predominant presentations were altered behaviour, loss of consciousness, 28.5% of mixed malaria and 2.6% of PF patients had cerebral malaria. INTERPRETATION AND CONCLUSION: Malaria being a common infectious disease encountered in day to day practice, early recognition and prompt intervention of complications due to malaria is necessary. Mainstay of treatment consists of appropriate antimalarial drug therapy, fluid replacement, and renal replacement therapy if needed and correction of anemia, thrombocytopenia.