Severe Plasmodium falciparum and Plasmodium vivax malaria among adults at Kassala Hospital, eastern Sudan

Abstract

BackgroundThere have been few published reports on severe Plasmodium falciparum and Plasmodium vivax malaria among adults in Africa.MethodsClinical pattern/manifestations of severe P. falciparum and P. vivax (according to World Health Organization 2000 criteria) were described in adult patients admitted to Kassala Hospital, eastern Sudan.ResultsA total of 139 adult patients (80 males, 57.6%) with a mean (SD) age of 37.2 (1.5) years presented with severe P. falciparum (113, 81.3%) or P. vivax (26, 18.7%) malaria. Manifestations among the 139 patients included hypotension (38, 27.3%), cerebral malaria (23, 16.5%), repeated convulsions (18, 13.0%), hypoglycaemia (15, 10.8%), hyperparasitaemia (14, 10.1%), jaundice (14, 10.1%), severe anaemia (10, 7.2%), bleeding (six, 4.3%), renal impairment (one, 0.7%) and more than one criteria (27, 19.4%). While the geometric mean of the parasite count was significantly higher in patients with severe P. vivax than with severe P. falciparum malaria (5,934.2 vs 13,906.6 asexual stage parasitaemia per μL, p = 0.013), the different disease manifestations were not significantly different between patients with P. falciparum or P. vivax malaria. Three patients (2.2%) died due to severe P. falciparum malaria. One had cerebral malaria, the second had renal impairment, jaundice and hypoglycaemia, and the third had repeated convulsions and hypotension.ConclusionsSevere malaria due to P. falciparum and P. vivax malaria is an existing entity among adults in eastern Sudan. Patients with severe P. falciparum and P. vivax develop similar disease manifestations.

Comparison of artesunate and quinine in the treatment of severe Plasmodium falciparum malaria at Kassala hospital, Sudan

“…The area is characterized by unstable malaria transmission [11]. The detail of the method and clinical part of the study was published recently [12]. In summary, after patients or guardians (in cases of comatose patients and children) signed an informed consent form, clinical data (temperature, weight, and fever history) were collected using questionnaires.…”

Comparative Features of Vivax, Falciparum and Mixed Malarial Infections in a Peripheral Hospital of Mumbai.

“…Vivax malaria does not have a benign course and this has been reported in several recent studies. (3)(4)(5)(6)14) .17% of our patients had splenomegaly while 13% had hepatomegaly. Splenomegaly was more common in mixed and vivax infections than in falciparum infections while hepatomegaly was more common in mixed and falciparum infections than in vivax infections.…”

“…(3)(4)(5)(6) A considerable number of patients are even presenting with mixed infection.The present study was conducted to do a comparative analysis of clinical presentation, diagnosis, biochemical and hematological profile of patients presenting with vivax falciparum and mixed infections in a peripheral hospital of Mumbai.…”

Malaria-associated hypoglycaemia in children

“…CFR were also lower among Plasmodium vivax infected individuals [43]. However, an Indian study showed that several complications including acute kidney injury, jaundice, severe anemia, metabolic acidosis, shock, hyperpyrexia, hypoglycemia, or generalized tonicclonic seizures were more prevalent in patients with Plasmodium vivax malaria than Plasmodium falciparum malaria [44].…”