Publication:

Clinical profile, laboratory profile of malaria cases attending a tertiary care hospital in South India: two-year study

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.