Comparison of clinical profile and severity of P. falciparum and P. vivax malaria in a tertiary care hospital of Surat, India

Abstract

Background: Surat is an endemic area for malaria. There has been a change in the trend of clinical profile and severity of P.vivax and P. falciparum malaria. Initially, P. falciparum was considered notorious for its complications but now P. vivax also presents with similar pictures. Hence, vivax malaria, which was once thought to be a relatively benign condition, is appearing in its more malignant form, with severity gradually becoming a serious concern. This aim of the study is to compare the clinical profile severity of P. vivax and P. falciparum malaria in pediatrics age group in a tertiary care hospital in Surat, India. Methods: A retrospective study was carried out at a tertiary care hospital of a medical college in Surat. This study was done for a period of 6 months from July 2014 to December 2014. Patients below 18 years of age who were smear positive for plasmodium species or malarial antigen positive were included in the study. Statistical analysis was done using chi square test for comparing proportions. P value < 0.05 was considered significant. Results: Eighty-seven patients were found to be suffering from malaria detected by malarial antigen test or through blood smear. Out of this, 48 (55%) patients were found to have P. vivax while 31 (35.6%) patients were found to have P. falciparum and only 8 cases had mixed malaria. The common complications encountered were jaundice and severe anemia. Severe malaria was more common in patients having vivax malaria as compared to falciparum. Besides anaemia as a haematological manifestation, thrombocytopenia was the second common abnormality encountered more commonly in patients with vivax as compared to falciparum species. The detailed study morbidity profile clearly establishes that severe malaria, earlier attributed to only falciparum is equally seen in vivax. Conclusions: Severe form of malaria is seen in vivax malaria and the age group affected by vivax also is younger. Profile of complications is different in different studies.

Analysis of clinical profile of malaria patients attending a tertiary care centre in Central India

“…Most common clinical presentation observed in our study were fever, weakness, anorexia, vomiting, nausea and headache, concordance with the patil C et al [33]. Common clinical signs of malaria in current study were pallor, Icterus, splenomegaly, hepatomegaly and hypotension, accordance with the Singh P, et al [34] and Hirani MM et al [35].…”

“…The malaria is classically characterized by fever with chills and rigors, occurring intermittently with splenomegaly and anaemia. Apart from this classical clinical presentation there may be involvement of central nervous system in cerebral malaria, gastrointestinal involvement in algid malaria, respiratory involvement in the form of acute pulmonary insufficiency [6][7]. The proportion of P. Vivax and P. falciparum varies in different parts of India.…”

Changing clinical profile of malaria at a tertiary care hospital

“…Apart from this classical clinical presentation there may be involvement of central nervous system in cerebral malaria, gastrointestinal involvement in algid malaria, respiratory involvement in the form of acute pulmonary insufficiency. 2,3 Lactic acidosis, hypoglycaemia, haematological and coagulation abnormalities and other presentations are also known.…”