The Unusual Presentation of a Usual Organism – the Changing Spectrum of the Clinical Manifestations of Plasmodium Vivax Malaria in Children: A Retrospective Study

Sharma, Shobha; Aggarwal, Kailash Chandra; Deswal, Shivani; Raut, Deepak; Roy, Neelam; Kapoor, Rohit

doi:10.7860/jcdr/2013/5633.3370

Cited by 9 publications

(5 citation statements)

References 26 publications

(23 reference statements)

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“…Of them, 26 studies were identified for consideration in quantitative synthesis [8] , [10] , [23] – [46] . Thirteen studies were excluded because (i) there was no comparator group [3] , [47] – [50] , (ii) there were no data on SM cases [51] – [54] , (iii) there were no data on P.vivax infection [55] , (iv) they were review articles [7] , [56] and (v) they were studies of a particular population (i.e military group) [57] .…”

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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“…15,16 Although, until recently, P. vivax infection has been thought to be mostly benign and rarely fatal, in recent years, P. vivax is increasingly being identified as considerably virulent and causes severe illnesses and mortality. [17][18][19][20][21][22][23] This is evident from the report that in several subregions of Peru, where malaria transmission is almost exclusively due to P. vivax, critical illnesses occur considerably. 23 Although several parts of the southwestern India are endemic to malaria, very little has been reported on the extent of disease severity and clinical complications in the Mangaluru region.…”

Section: Introductionmentioning

confidence: 97%

Malaria Severity in Mangaluru City in the Southwestern Coastal Region of India

Dayanand

Punnath

Chandrashekar

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Dakshina Kannada district in the Southwestern region of Karnataka state, India, including Mangaluru city is endemic to malaria. About 80% of malaria infections in Mangaluru and its surrounding areas are caused by Plasmodium vivax and the remainder is due to Plasmodium falciparum. Malaria-associated clinical complications significantly occur in this region. Here, we report the pathological conditions of 41 cases of fatal severe malaria, admitted to the district government hospital in Mangaluru city during January 2013 through December 2016. The results of clinical, hematological, and biochemical analyses showed that most of these severe malaria cases were associated with thrombocytopenia, anemia, metabolic acidosis, acute respiratory distress, and single or multi-organ dysfunction involving liver, kidney, and brain. Of the 41 fatal malaria cases, 24, 10, and seven patients had P. vivax, P. falciparum, and P. vivax and P. falciparum mixed infections, respectively. These data suggest that besides P. falciparum that is known to extensively cause severe and fatal malaria illnesses, P. vivax causes fatal illnesses substantially in this region, an observation that is consistent with recent findings in other regions.

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“…Malaria is a vector-borne disease that poses serious threat to human life and is endemic throughout the tropics [1]. Classically severe malaria is known to be associated with Plasmodium falciparum [2]. Various studies across the globe have reported the presence of severe life-threatening symptoms in Plasmodium vivax patients [3–5].…”

Section: Introductionmentioning

confidence: 99%

Exploration of genetic diversity of Plasmodium vivax circumsporozoite protein (Pvcsp) and Plasmodium vivax sexual stage antigen (Pvs25) among North Indian isolates

Kaur

Sehgal

Kumar

et al. 2019

Malar J

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Background Malaria is one of the important vector-borne diseases with high fatality rates in tropical countries. The pattern of emergence and spread of novel antigenic variants, leading to escape of vaccine-induced immunity might be factors responsible for severe malaria. A high level of polymorphism has been reported among malarial antigens which are under selection pressure imposed by host immunity. There are limited reports available on comparative stage-specific genetic diversity among Plasmodium vivax candidate genes in complicated vivax malaria. The present study was planned to study genetic diversity ( Pvcsp and Pvs25 ) among complicated and uncomplicated P. vivax isolates. Methods Pvcsp and Pvs2 -specific PCRs and DNA sequencing were performed on P. vivax PCR positive samples. Genetic diversity was analysed using appropriate software. Results The present study was carried out on 143 P. vivax clinical isolates, collected from Postgraduate Institute of Medical Education and Research, Chandigarh. Among the classic and variant types of Pvcsp , the VK210 (99%; 115/116) was found to be predominant in both complicated and uncomplicated group isolates. Out of the various peptide repeat motifs (PRMs) observed, GDRADGQPA (PRM1) and GDRAAGQPA (PRM2) was the most widely distributed among the P. vivax isolates. Whereas among the Pvs25 isolates, 100% of double mutants (E97 Q /I130 T ) in both the complicated (45/45) as well as in the uncomplicated (81/81) group was observed. Conclusion An analysis of genetic variability enables an understanding of the role of genetic variants in severe vivax malaria.

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The Unusual Presentation of a Usual Organism – the Changing Spectrum of the Clinical Manifestations of Plasmodium Vivax Malaria in Children: A Retrospective Study

Cited by 9 publications

References 26 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

Malaria Severity in Mangaluru City in the Southwestern Coastal Region of India

Exploration of genetic diversity of Plasmodium vivax circumsporozoite protein (Pvcsp) and Plasmodium vivax sexual stage antigen (Pvs25) among North Indian isolates

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