Severe vivax malaria trends in the last two years: a study from a tertiary care centre, Delhi, India
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Annals of Clinical Microbiology and Antimicrobials Open Access
RESEARCH
Severe vivax malaria trends in the last two years: a study from a tertiary care centre, Delhi, India Monika Matlani1, Loick P. Kojom2, Neelangi Mishra1, Vinita Dogra1 and Vineeta Singh2*
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. Keywords: Plasmodium vivax, Vivax malaria, Clinical trends, Disease severity, India Background Malaria still remainsa global public health problem. According to the World Malaria Report 2019, India accounts for 4% of all estimated cases of malaria worldwide [1]. India is an endemic region with more than half of the population [698 million] at risk for malaria infections annually where Plasmodium vivax is solely responsible for about 50% of the reported malaria cases [2]. A broad spectrum of clinical features may be manifested in *Correspondence: [email protected] 2 Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, New Delhi, India Full list of author information is available at the end of the article
humans following the bite of female Anopheles mosquitoes with inoculation of the Plasmodium species into the blood circulation, leading to asymptomatic parasitaemia, uncomplicated and severe malaria with associated deaths [3]. The outcome of the malaria disease is influenced by various factors like infecting Plasmodium species, host immunity and efficacy of treatment [4]. In endemic areas, some of the important risk factors re
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