Clinical profile, laboratory profile of malaria cases attending a tertiary care hospital in South India: two-year study
DOI:
https://doi.org/10.18203/2349-3933.ijam20171057Keywords:
Anemia, Cerebral malaria, Falciparum malaria, Splenomegaly, Vivax malariaAbstract
Background: Malaria a protozoal disease caused by Plasmodium species. As per WHO global report 2015, it is distributed in 100 countries throughout the world. The worldwide prevalence of malaria is around 200-300 million cases with an estimated economical loss of 0.5-1 billion per annum. India contributes to 70% of cases and 69% of deaths in south east Asian region. Malaria in India is caused mainly by two species P. vivax (Pv) and P. falciparum (Pf). The present study was done to evaluate the clinical profile of malarial cases with associated complications and hematological profile in these cases. This study will provide insight into the common species distribution and their clinical presentations with hematological profile.
Methods: The present study was conducted at Narayana general hospital and medical college for two years from March 2014 to February 2016. Study was conducted on 400 confirmed cases of malaria with 200 males and 200 females. Clinical presentations with signs and symptoms were noted and laboratory parameters of cases were noted.
Results: 127 cases of vivax, 243 cases of falciparum and 30 cases of mixed infections were identified. 41-50 years (33.3%) age group was predominantly affected. Fever was the most common symptom (100%) followed by chills (83%). Pallor was the most common sign (76%) followed by splenomegaly (71%). Cerebral malaria was seen in 42 cases, severe anemia in 82, ARDS in 4 and circulatory collapse in 1 case was identified. ESR, PT, BT and APTT were raised in both falciparum and vivax malaria. Severe thrombocytopenia was identified in 100 cases with petechia and minor bleeding manifestations.
Conclusions: To conclude falciparum malaria was more common than vivax malaria in our study with more cases of severe anemia, splenomegaly, cerebral malaria, and severe thrombocytopenia. BT, PT, APTT were raised more in cases of falciparum than vivax malaria. In cases of mixed infections of vivax and falciparum, clinical profile and laboratory indices were more presenting as falciparum than vivax malaria.Metrics
References
Murray CJL, Lopez AD. Evidence based health policy- Lessons from the Global Burden of Disease Study. Science. 1996;274:740-3.
World Health Organization. World malaria report 2015. Geneva: WHO, 2015. World Health Organization. Global technical strategy for malaria 2016-2030. Geneva: WHO. 2015.
Kumar A, Valecha N, Jain T, Dash AP. Burden of malaria in India: retrospective and prospective view. Am J Trop Med Hyg. 2007;77(6):69-78.
Srinivas SV. Clinical profile of falciparum malaria with special reference to complications and outcome. RGUHS. 2010;22:23-9.
Wasnik PN, Manohar TP, Humaney NR, Salkar HR. Study of clinical profile of malaria in tertiary referral centre in Central India. JAPI. 2001;2:33-6.
Ministry of Health and Family Welfare, Government of India. Strategic plan for malaria control in India 2012-2017: a five-year strategic plan. New Delhi. http:// nvbdcp.gov.in/ Doc/ Strategic-Action-Plan-Malaria-2012-17-Co.pdf- (Accessed on 8 Feb 2016).
Rojanasthien S, Surakamolleart V, Boonpucknavig S, Isarangkura P. Hematological and coagulation studies in Malaria. J Med Assoc Thailand. 1992;75(17):190-4.
Mehta A. Clinical pattern of Malaria epidemics in Rajasthan. J Phys India. 2001;48:211-5.
Ramana KNS, Reddy MD. Clinco-hematological profile of patients with falciparum malaria. Ann Int Med Den Res. 2016;2(1):234-7.
Newton SR. Cerebral Malaria. J neuro Neurosurg Psy. 2000;69:433-41.
Sen R, Tewari AD, Sehgal PK, Singh U, Sikka R, Sen J. Clinicoo-haematological profile in Acute and chronic falciparum malaria in children. J Commun Dis. 1994;26(1):31-8.
Dash HS, Padhy S. Study of clinical and laboratory profile in malaria. Indian J Applied Res. 2015;5(12):218-22.
Nond B. Dysfunction in Malaria. J Asso phy India. 1999;47(1):103-7.
Harris VK, Richard VS, Mathai E, Sitaram U, Kumar VK, Cherian AM, et al. Study of clinical profile of falciparum malaria in tertiary care hospital in south India. Indian J Malariol. 2001;38:19-24.
Garg RK. Cerebral Malaria. JAPI. 2000;48:1004-13.
Bajiya HN, Kochar DK. Incidence and neurological sequelae in survivors of cerebral malaria. JAPI. 1996;44:679-81.
Phillips R, Pasvol G. Anemia of P. falciparum malaria. Bailliere’s Clin Hematol. 1992;5:315-30.
Francischetti IMB, Seydel KB, Monteiro RQ. Blood coagulation, inflammation and malaria. Microcirculation. 2008;15(2):81-107
Miller LH, Baruch DI, Marsh K, Doumbo OK. The pathogenic basis of malaria. Nature. 2002;415:673674.
Mohanty N, Satpathy SK, Nanda P. Hepatopathy in complicated falciparum malaria. Report from Eastern India. Trans Rsoc trop Med Hyg. 2004;98;753-4.
Jayashankar CA, Pinnelli VB, Prabhu R. Alteration of coagulation profile in malaria patients and its correlation with degree of parasitemia: a prospective study. Int J Adv Med. 2016;3:388-92.
Looareesuwan S, Davis JG, Allen DL, Lee SH, Bunnag D, White NJ. Thrombocytopenia in malaria. South East Anar J Trop Med Pub Hygiene. 1992;23(1):44-50.
Ghosh K, Shetty S. Blood coagulation in falciparum malaria. Parasitol Res. 2008;102(4):571-6.