A Study ON Clinical Presentation and Outcome of Malaria from an Underreported P vivax Predominant Region of North India
P. falciparum is the most prevalent and dangerous species causing malaria worldwide. But in contrast to this P. vivax, known to cause benign malaria infection is the commonest species in our region (Uttar Pradesh) and is treated mainly with chloroquine. However in recent years many researchers have come up with the conclusion that P. vivax is changing its clinical pattern and has complications similar to P. falciparum. Due to paucity of studies from our region, poor health infrastructure and to know the present scenario of P. vivax clinical spectrum in our region we conducted a comparative study between different species causing malaria in our region. All febrile adult patients 18 years of age) admitted in medicine department, were tested for malaria parasites. Total 387 patients of malaria were enrolled who met both inclusion and exclusion criteria. Frequencies of alterations in clinical, biochemical parameters and outcome were determined in various plasmodium species. Data was analysed using appropriate statistical tests. Out of 387 patients, 297 were P. vivax, 54 were P. falciparum, and 36 were mixed infection. The complications seen in vivax malaria were: severe thrombocytopenia (39.4% ARDS (15.33% Hyperbilirubinemia (22.2% AKI (12.3% severe anaemia (21.21% bleeding (6.06% cerebral malaria (9.04% seizure (3.03% and death (3.5% In our region also P. vivax is emerging to cause Severe and fatal malaria. Further molecular research, status of chloroquine sensitivity and clinical studies is required in the state to understand emergence of severe malaria in vivax mono infection.