Severe vivax malaria trends in the last two years: a study from a tertiary care centre, Delhi, India

Abstract

Background Plasmodium vivax, once considered benign species, is recently being recognised to be causing severe malaria like Plasmodium falciparum. In the present study, the authors report the trends in malaria severity in P. vivax among patients from a Delhi government hospital. The aim of the study was to understand the disease severity and the burden of severe vivax malaria. Methods A hospital based study was carried out from June 2017 to December 2018 at a tertiary care centre from Delhi, India. Patients were tested for malaria using peripheral blood smear (PBS) and/or rapid malaria antigen test (RMAT). The severe and non-severe vivax malaria categorization was done as per the WHO guidelines. Sociodemographic, clinic and paraclinical data were collected from patients and their medical records. Results Of the 205 patients, 177 (86.3%) had P. vivax infection, 22 (10.7%) had P. falciparum infection and six (2.9%) had mixed infection with both the species. Out of 177 P. vivax cases included in this study one or more manifestations of severe malaria was found in 58 cases (32.7%). Severe anaemia (56.9%), jaundice (15%) and significant bleeding (15%) were the most common complications reported in most of patients, along with thrombocytopenia. Conclusions In this study, it is evident that vivax malaria is emerging as the new severe disease in malaria patients, a significant shift in the paradigm of P. vivax pathogenesis. The spectrum of complications and alterations in the laboratory parameters in P. vivax clinical cases also indicate the recent shift in the disease severity.

Vivax Malaria and the Potential Role of the Subtelomeric Multigene vir Superfamily

“…Together, P. falciparum and P. vivax are responsible for approximately 90% of malaria cases worldwide. While P. falciparum infection is associated with high mortality, reports of severe vivax malaria have increased over the last decade [3,4].…”

Magnitude and patterns of severe Plasmodium vivax monoinfection in Vietnam: a 4-year single-center retrospective study

“…These manifestations include impaired consciousness, prostration, multiple convulsions, acidosis, hypoglycemia, severe malarial anemia, renal impairment, jaundice, pulmonary edema, significant bleeding, and shock ( 17 ). However, despite these recognized severe manifestations and a recent recognition that P. vivax can cause deaths, there are still insufficient data that quantify the exact burden and patterns of severe P. vivax monoinfections, especially in P. vivax endemic regions ( 6 ).…”

A Tale of Two Parasites: A Glimpse into the RNA Methylome of Patient-derivedP. falciparumandP. vivaxisolates

“…While the rapid progression of case morbidity in P. falciparum malaria has been well-documented, an increasing number of reports of severe clinical complications caused by P. vivax infections have surfaced, with the recent bouts of P. vivax resurgence in the US [2], which had been certified malaria-free since the 1970s. We published the first detailed report of severe P. vivax infection from India validated by diagnostic PCR [3][4][5].…”