Publication:

Changes in clinical manifestations in children with vivax malaria

Background There is an increased concern about the increasing virulence of Plasmodium vivax. The disease which was associated with relatively benign illness previously, is now increasingly witnessed in severe forms and with complications. Therefore we decided to look at our data over last 13 years if there is an increasing trend with regard to severity and complications of vivax malaria.

Methods The data from 133 children with vivax malaria diagnosed with thick and thin smear over a period ranging from2011 to 2013. For the purpose of comparison, we divided the data into 3 time periods A, B & C respectively. The data was analyzed to see if there is an increase in severity of vivax malaria.

Results There was a general increase in incidence of complications in children with vivax malaria. Incidence of shock increased from 2.9% in time period A to 25.9% in time period B and 28.6% in time period C and the change was statistically significant. This increase was also observed in incidence of respiratory distress, acute lung injury, bleeding manifestations and disseminated intravascular coagulation. However none of these changes were statistically significant. There was no change in the incidence of cerebral malaria.

Conclusions There appears to be an increase in severity and complications in vivax malaria in children. Clinicians need to be aware of this trend while managing children with vivax malaria.