International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 6, Issue 9 (2020)

Study of contribution by Plasmodium vivax to malarial morbidity among children hospitalized with severe malaria in a tertiary level hospital of northern India


Rajesh kumar, Nikki kumari, Binod Kumar Singh, Md. Athar Ansari

Background and Objectives: Malaria is one of the most widespread infectious diseases of tropical countries with Plasmodium falciparum being the most prevalent malaria parasite in WHO South-East Asia Region (SEAR). However, Plasmodium vivax also is now being realized to cause severe life-threatening disease. Objective of this research was to study the profile of severe malaria and contribution of vivax infection to malarial morbidity in North Indian children. Methods:It is a single centre, prospective, observational study conducted over the period of 1 year in a tertiary level teaching hospital in northern India. All patients of age < 15 years, admitted during the study period with diagnosis of severe malaria, as per World Health Organization (WHO) (2014) criteria, were enrolled in the study. Patients were categorized into either of three groups: P. vivax (Pv) monoinfection, P. falciparum (Pf) monoinfection and mixed P. vivax with P. falciparum infection (Pf+Pv) and were analyzed for clinical and epidemiological profile. Furthermore, contribution of Plasmodium vivax to the severe malarial morbidity was studied. Results:Out of 1880 children screened, 27 children were diagnosed to be having severe malaria. Out of theses, 51.8% (n=14) had P. vivax (Pv) mono-infection, 18.5% (n=5) had mixed infection with both vivax and falciparum and only 29.6% (n=8) had P. falciparum (Pf) mono-infection. Pv patients had much wider age range compared to Pf, though median age was similar in all groups. However, proportion of patients from younger age group (<5 y) was significantly higher in Pv group. The clinical features on admission were similar in all the groups. Duration of illness and hospitalization were also similar in all groups with shorter median duration of symptoms in Pf group. Among various clinical syndromes, severe anemia, cerebral malaria and hepatitis were common to all groups. Severe anemia and shock were more frequently observed in Pf group whereas cerebral malaria, hepatitis, acute kidney injury (AKI), acute respiratory distress syndrome (ARDS) and bleeding symptoms were more commonly seen in Pv patients. Interpretation & conclusion:Factors associated with severe malaria and resulting mortality, identified in this study were consistent with other studies. This research shows that severe malaria is still an important cause of morbidity and mortality among young children. It was concluded that vivax malaria is emerging as an important cause of malaria-related complications, including death in children.
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