Clinical spectrum and treatment outcome of severe malaria caused by<i>Plasmodium vivax</i>in 18 children from northern India

Gehlawat, Virender Kumar; Arya, Vandana; Kaushik, Jaya Shankar; Gathwala, Geeta

doi:10.1179/2047773213y.0000000096

Cited by 17 publications

(17 citation statements)

References 10 publications

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“…Some studies failed to address the assessment of ‘common outcomes’ [10], [28], [30], [35], [37], [41], [42], [44], [45]. Failure to address any of these important criteria could affect the validity of their study process and/or outcome measurements.…”

Section: Resultsmentioning

confidence: 99%

Is Plasmodium vivax Malaria a Severe Malaria?: A Systematic Review and Meta-Analysis

et al. 2014

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Background Plasmodium vivax is one of the major species of malaria infecting humans. Although emphasis on P. falciparum is appropriate, the burden of vivax malaria should be given due attention. This study aimed to synthesize the evidence on severe malaria in P. vivax infection compared with that in P. falciparum infection.Methods/Principal FindingsWe searched relevant studies in electronic databases. The main outcomes required for inclusion in the review were mortality, severe malaria (SM) and severe anaemia (SA). The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Overall, 26 studies were included. The main meta-analysis was restricted to the high quality studies. Eight studies (n = 27490) compared the incidence of SM between P. vivax infection and P. falciparum mono-infection; a comparable incidence was found in infants (OR: 0.45, 95% CI:0.04–5.68, I 2:98%), under 5 year age group (OR: 2.06, 95% CI: 0.83–5.1, I 2:83%), the 5–15 year-age group (OR: 0.6, 95% CI: 0.31–1.16, I 2:81%) and adults (OR: 0.83, 95% CI: 0.67–1.03, I 2:25%). Six studies reported the incidences of SA in P. vivax infection and P. falciparum mono-infection; a comparable incidence of SA was found among infants (OR: 3.47, 95%:0.64–18.94, I 2: 92%), the 5–15 year-age group (OR:0.71, 95% CI: 0.06–8.57, I 2:82%). This was significantly lower in adults (OR:0.75, 95% CI: 0.62–0.92, I 2:0%). Five studies (n = 71079) compared the mortality rate between vivax malaria and falciparum malaria. A lower rate of mortality was found in infants with vivax malaria (OR:0.61, 95% CI:0.5–0.76, I 2:0%), while this was comparable in the 5–15 year- age group (OR: 0.43, 95% CI:0.06–2.91, I 2:84%) and the children of unspecified-age group (OR: 0.77, 95% CI:0.59–1.01, I 2:0%).ConclusionOverall, the present analysis identified that the incidence of SM in patients infected with P. vivax was considerable, indicating that P. vivax is a major cause of SM. Awareness of the clinical manifestations of vivax malaria should prompt early detection. Subsequent treatment and monitoring of complications can be life-saving.

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Section: Resultsmentioning

confidence: 99%

Is Plasmodium vivax Malaria a Severe Malaria?: A Systematic Review and Meta-Analysis

et al. 2014

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“…In present study we found that children having malaria presented with fever (24, 100%) 18 The stool examination showed the frequency of parasitic infection was Amoeba 1 (7.1%), Giardia 1 (7.1%), Ascariasis 6 (42%), and Hookworms 6 (42%) in total of 14 cases. Bechir et al in their study found that prevalence of intestinal parasitic infection was 75% (CI 68-83) among women and 60% (CI 53-66) among children.…”

mentioning

confidence: 45%

A study of pattern of some common infections in children one month to five years of age

Saikia

Sharma²

2018

Int J Contemp Pediatr

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Background: Understanding the causes of child mortality provides important public health insights. Globally 6.9 million deaths in children under-5 occurred in 2011. The objective of the present study was to study the pattern of some common infections in children one month to five years of ageMethods: Observational descriptive study was conducted at Department of Paediatric from July 2012 to June 2013 among 368 randomly selected children. Standard diagnostic criteria for Respiratory tract infection, Diarrhea, Tuberculosis, Urinary tract infection, Malaria, Enteric fever, Measles, Pyoderma, Parasitic infections was followed for all children.Results: Respiratory tract infection and Diarrhea occurred most frequently in 7 to 24 month of child that was 82 (51.9%) and 53 (58.2%), respectively. Stool examination in Parasitic infestation showed that Amoeba 1 (7.1%), Giardia 1 (7.1%), Ascariasis 6 (42%), and Hookworms were 6 (42%) in total of 14 cases. Anemia was present in URI, Tuberculosis, Malaria, and Parasitic infestation with mean hemoglobin (Hb) ranges from 8.6 to 9.2. Mantoux showed that 20 (87%) cases had mantoux > 10 mm. Malarial species found were Vivax (16, 66.7%). Respiratory tract infection occurred mostly in winter season.Conclusions: Most common infections in children 1 month to 5 years of age was Respiratory tract infection followed by diarrhea, enteric fever, malaria, tuberculosis, urinary tract infection, parasitic infection, measles and pyoderma.

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“…But no research could be found to establish relation between artseunate therapy and malaria-induced bleeding. 13 So this observation needs further validation.…”

Section: Outcomementioning

confidence: 95%

“…13 In another study by Desai PD et al, 90% patients with cerebral malaria recovered after getting injectable Artesunate.…”

Section: Outcomementioning

confidence: 95%

“…In the study by Gehlawat VK et al, all 18 children with severe malaria who were treated with intravenous Artesunate followed by a course of artemether-lumefantrine combination showed a reasonable clinical response with no evidence of early or late treatment failures. 13 Bleeding was observed in 22% (n = 4) patients at the time of admission. 11.1% (n = 2) of them improved whereas bleeding persisted in 11.1% (n = 2) patients and 22.2% (n = 2) started bleeding later.…”

Section: Outcomementioning

confidence: 98%

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Study clinical response and parasite clearance response to Artemisinins in severe malaria in children

Ghanghoriya

Srivastava

Bharti

2018

Int J Contemp Pediatr

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Background: The research was conducted to study the clinical response and parasite clearance response to Artesunate therapy, in children admitted with severe malaria at a tertiary care centre in Central India.Methods: It is a prospective analytical study. 18 microscopy positive children diagnosed with severe malaria were included. Baseline blood samples collected for microscopy and biochemical tests. All patients were administered standard intravenous Artesunate therapy and were watched every 12 hourly for: 1. Resolution of clinical signs and symptoms. Clinical parameters included level of consciousness in form of GCS, vital signs like pulse rate, respiration, signs of bleeding, development of icterus, pallor, urine output and laboratory parameters included blood sugar levels, renal and liver function tests. 2. Time taken for conversion of microscopic Smear positive to Smear negative.Results: The mean age was 8.34±4.35 years. Males and females were equally affected. 61% of severe malaria patients were infected by P. falciparum and remaining were infected by P. vivax. The most common clinical features were Pallor: 100%, Respiratory distress: 66.7%, Cerebral malaria: 55.6%. After giving Artesunate therapy, Mean GCS in Cerebral malaria patients showed improvement (on admission: 9±1.15, at 72 hours: 12.5±3.7). Effect was marginally better in P. vivax cases. Respiratory distress and tachycardia improved in majority of patients (75% and 80% respectively). The number of patients with icterus progressively increased. Improvement in liver function and renal function was minimal. 100% parasite clearance was achieved. The mean parasite clearance time is 46±9.43 hours. 72.2% were successfully discharged, 22.2% took Leave Against Medical Advice (LAMA) and 5.6% certified dead.Conclusions: Artesunate is an effective drug in severe malaria patients in terms of rapid improvement of cerebral function, improvement and stabilization of vitals, parasite clearance with favorable long-term outcome. There is no evidence of plasmodium resistance to Artesunate currently as per the present study.

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

Cited by 17 publications

References 10 publications

Is Plasmodium vivax Malaria a Severe Malaria?: A Systematic Review and Meta-Analysis

Is Plasmodium vivax Malaria a Severe Malaria?: A Systematic Review and Meta-Analysis

A study of pattern of some common infections in children one month to five years of age

Study clinical response and parasite clearance response to Artemisinins in severe malaria in children

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