Journal of Communicable Diseases

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    A Study of Social Status of People with Disabilities due to Leprosy in Desert Part of Rajasthan, India.
    (2011-09) Yadav, S P
    Leprosy is a stigmatized disease in our society. Ninety-eight disabled leprosy patients were studied in areas of Pokaran CHC and Ramdeora PHC of Jaisalmer district. About ninety-five per cent (94.6%) leprosy patients were found discarded by their life partners due to disabilities. A positive relationship was found between social stigma and deformity due to disease. IEC need to be done at community level also for changing attitude and behaviour towards leprosy patients.
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    Fecal Contamination of Drinking Water Supplies in and around Chandigarh and Correlation with Acute Gastroenteritis.
    (2011-09) Taneja, Neelam; Singh, Malkit; Rao, Pooja; Biswal, Manisha; Priya, Shiva; Chander, Ram; Sharma, Meera
    The study evaluated drinking water from localities in and around Chandigarh for fecal coliforms, V.cholerae and Enterotoxigenic E.coli and correlate with occurrence of acute gastroenteritis occurring from the same region. Drinking water sample were collected from various sources from the defined area. Samples were tested for fecal coliforms and E.coli count by multiple tube method and pathogens by membrane filtration technique. E. coli were screened for heat labile toxin (LT) by the reverse passive agglutination method and heat stable toxin (ST) by ELISA. Stool samples from cases of acute gastroenteritis from the same region and time were collected and processed for V. cholerae, Enterotoxigenic E coli (ETEC) and others like Salmonella, Shigella and Aeromonas spp. Of 364 water samples examined, 116 (31.8%) samples were contaminated with fecal coliforms (58.5% rural, 33.4% semi-urban and 11.1% from urban areas). E. coli were grown from 58 samples. Ninety-two isolates of E. coli were tested for enterotoxins of which 8 and 24 were positive for LT and ST respectively. V. cholerae were isolated from 2 samples during the outbreak investigation. Stored water samples showed a significantly higher level of contamination and most of Enterotoxigenic E. coli were isolated from stored water samples. A total of 780 acute gastroenteritis cases occurred; 445 from semiurban, 265 rural and 70 from urban areas. Out of 189 stool samples submitted, ETEC were the commonest (30%) followed by V. cholerae (19%), Shigellae (8.4%), Salmonellae (2.1%) and Aeromonas (2.6%). ST-ETEC (40/57) were commoner than LT- ETEC(17/57). In the present study, high levels of contamination of drinking water supplies (32.1%) correlated well with cases of acute gastroenteritis. Majority of cases of acute gastroenteritis occurred in the semi-urban area corresponding with high level of contamination (33.4%). The highest level of water contamination was seen in rural areas (58.5%) but the number of acute gastroenteritis cases were lesser (33.9%) as ponds were infrequently used for drinking purpose. Safer household water storage and treatment is recommended to prevent acute gastroenteritis, together with point-of-use water quality monitoring.
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    Epidemiological Significance of the Breeding of Mosquitoes in Discarded Automobile Tyres in Zaria, Northern Nigeria.
    (2011-09) Adebote, D A; Kogi, E; Oniye, S J; Akoje, F
    Waste automobile tyres are suitable receptacles of rainwater thus capable of supporting the breeding of vector mosquito species in close proximity to humans and altering disease transmission risks. Bionomics of mosquitoes in carelessly discarded tyres was explored to unravel species composition and abundance, physicochemical parameters of microhabitats and epidemiological significance. Of the 1179 larvae isolated from 90/212(42.45%) positive tyres were ten species belonging to Aedes and Culex genera, including Aedes aegypti (46.56%), Culex albiventris (0.25%), Cx. cinereus (0.25%), Cx. grahami (0.68%), Cx. ingrami (1.44%), Cx. nebulosus (2.37%), Cx. mirificus (0.08%), Cx. pipiens pipiens (0.17%), Cx. quinquefasciatus (47.07%) and Cx. tigripes (1.10%). Abundance of the dominant Ae. aegypti and Cx. quinquefasciatus did not differ significantly ( P > 0.05), but was higher than those of the other eight species (P < 0.05). The microhabitat pH (range 5.20-9.50), total dissolved solids (range 15-802ppm) and electrical conductivity (range 30-1603μscm- 1) were obtained in tyres. Abundance of Cx. quinquefasciatus correlated positively and significantly with EC and TDS of breeding water (P < 0.05). The study revealed high potential of the transmission of filariasis and arboviruses including dengue and yellow fever by mosquitoes domiciled in waste tyres.
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    Whole Cell Pertussis Vaccine : Reducing Toxicity.
    (2011-09) Datta, Thakur; Sharma, Devender; Gandhoke, Inderjeet; Khare, Shashi; Bhardwaj, Arun
    Since introduction of the pertussis vaccine in 1940’s the morbidity and mortality due to the infection has been markedly reduced all over the world. However the adverse effects of the inactivated whole cell pertussis vaccine like pain, swelling at the site of injection, fever, vomiting anorexia, persistent crying & drowsiness have been the cause of great concern, till date. Also the safety concerns over the use of thiomersal as an inactivating agent as well preservative have been raised in the recent past. Studies in many countries have been initiated to reduce or replace thiomersal & using other inactivating agents in the vaccines. Limited studies have been conducted in India. The present study has been undertaken as an attempt to reduce the quantity of thiomersal and modification in the procedure of production of the pertussis vaccine to reduce the toxicity, to produce better quality of whole cell pertussis vaccine. To achieve this, at the time of production of the whole cell pertussis vaccine, at Kasauli, as per the standard procedure recommended by WHO, three parallel batches of the pertussis culture were inactivated in fermenter before harvesting and thiomersal was used only one time for suspending the bacterial mass after harvesting. The resultant modified vaccine so prepared when tested showed that it was of better quality as compared to the one produced by standard procedure, when tested in mice.
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    Detection of Enzootic Plague Foci in Peninsular India.
    (2011-09) Biswas, Shyamal; Lal, Sohan; Mittal, Veena; Malini, M; Kumar, Shiv
    A Continuous serological and bacteriological surveillance in rodents was carried out in peninsular India i.e. Andhra Pradesh, Karnataka and Tamil Nadu to detect the role of different species of rodents in the maintenance of active enzootic plague foci. Live rodents were collected from wild and ruderal/peri-domestic situations by digging and trapping for sera and organ samples. During 1989 to 2007 serological evidence of plague was detected in different species of rodents in peninsular India. Plague antibodies were detected in 243 sera samples in three different rodent species. Sero-positivity (0.042 percent) amongst rodents tested were found in Tatera indica cuvieri (Hardwicke) followed by Rattus rattus and Bandicota bengalensis. Regular plague surveillance work enhanced the possibility of detecting and delimiting plague foci and helped in implementing necessary preventive anti plague measures to prevent the occurrence of human plague.
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    An Epidemiological Investigation of A Multisource Outbreak of Crimean-Congo Hemorrhagic Fever in Gujarat.
    (2011-09) Gandhi, Sudhir; Dave, Paresh; Patel, G C; Khatri, H J; Shah, Nitesh; Mishra, Umang
    It all started with the report from Shalby Hospital, Ahmedabad of two deaths with unusual presentation on Jan 18, 2011. Immediately investigations were carried out; to identify the etiological agent, source of outbreak, and mode of transmission, as well as, to propose a control measure based on the findings of the investigation. Extensive literature search, discussion with various scientific institutions, scientists and laboratory diagnosis suggested it to be case of Crimean-Congo Hemorrhagic Fever (CCHF). Accordingly a Case definition was worked out to further investigate the episode/outbreak. Door-to-door survey was carried out and hospital records were scrutinized. Collected data was analyzed in terms of time, place, and person. Laboratory investigation reports of case patients were also collated. We conducted environment investigation to find out the source of Infection. A total 13 case patients of CCHF were identified out of which 9 are positive for CCHF virus, 2 were negative for CCHF virus and in 2 instances, samples could not be taken because of early deaths of the cases. Among these 13 cases, 30.76 % mortality rate was noted. Cases were reported in middle age group only. Environmental investigation also confirmed the presence of CCHF virus in Ticks. The outbreak was due to CCHF virus. State wide sero surveillance in animals is needed to identify prevalence of disease in Gujarat.
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    HIV/AIDS –How Aware are Automobile Workers of Kolkata.
    (2011-06) Ghosh, Santanu; Samanta, Amrita; Mukhopadhyay, Prianka
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    Sero-prevalence of Anti-HCV in HIV Infected Patients.
    (2011-06) Sonth, Suresh B; Satyhanarayana, M S; Mariraj, J; Krishna, S
    Human immunodeficiency virus (HIV) is known to influence the natural history of infections with certain hepatitis viruses and interactions between HIV and hepatitis viruses may potentiate HIV replication. There is high degree of epidemiological similarity between hepatitis B virus and HIV as regard to high-risk group and route of transmission. Limited information is available about the prevalence of hepatitis C virus in patients with human immunodeficiency virus in relation to specific risk factors or about the influence of hepatitis C virus coinfection on survival. Present study deals with the study of concurrent infection of HCV with HIV infection. In the study of 110 HIV seropositive patients, 6 (5.45%) were positive for HCV. The difference was highly significant compared to controls (p value < 0.0001). The studies of association of HCV in HIV cases are rare in India. Therefore the present study was undertaken to look at the prevalence of HCV in different groups and different stages of HIV infected patients.
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    Knowledge Attitude Practice Study on Pulse Polio Immunization in Mangalore, Dakshina Kannada District, Karnataka.
    (2011-06) Nitin, Joseph; Subba, S H; Shashidhar, Kotian M
    Government of India launched PPI in 1995 to eradicate polio by the end of 2000. Despite this 733 cases were reported last year alone. There is a need to understand the reason behind high number of cases being reported even after so many years of programme implementation. This study was therefore conducted to assess knowledge of people about polio and PPI, their attitude and practice towards PPI. This cross sectional study was done in Mangalore city of Karnataka. Only houses having under five children were taken for the study. Data was collected by interviewing any adult member of the household using a pretested questionnaire. Out of 100 participants 99 were literates but only 11 knew the correct mode of transmission of polio. Twenty seven had misconception that polio is a curable disease. Only 40 participants knew that polio drops can be given to children even with mild illnesses. Few (2%) participants felt that PPI causes vaccine overdose and 8 participants thought PPI to be a substitute for routine immunization. This study identified few important misconceptions associated with polio and PPI. This needs to be addressed by large scale awareness campaigns in order to eradicate polio in the near future.
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    Situation Analysis of Malaria in Godda District of Jharkhand During Malaria Epidemic.
    (2011-06) Singh, R K; Dhiman, R C; Das, M K
    The epidemiological and entomological investigations were carried out in 18 tribal villages of Godda district of Jharkhand state revealed average slide positivity rate (SPR) 9.9% and slide positivity rate for Plasmodium falciparum (SfR) 5.0%, respectively. P. falciparum was the dominant parasite accounting 51.2 per cent of the total infections. All the villages are situated in the deep forest and forest fringes. A total of 416 blood slides were collected and examined. Out of which 41 slides were found positive for malaria parasite (21 positive for P. falciparum and 20 positive for P. vivax). All the positive cases were treated with Blister Packs of anti-malarial of chloroquine and primaquine as per NBVDCP schedule to prevent further transmission of malaria, which were available. Rapid diagnostic Kits were used selectively only on the recommendation of the Physician/Medical Officer. Results of house to house fever survey indicated the presence of high percentage of symptomatic carriers of malaria parasites in the local population and in our study Pf % is more than reported data by District Malaria Office, Godda district, Jharkhand. In entomological studies, for mosquito fauna with reference to both Anopheline, 11 species belonging to one genus Anopheles were collected and identified during the survey; among them some species were most prevalent. A total of 599 mosquitoes were recorded and average density of mosquitoes recorded was 13.19 in human dwellings and 86.11 in cattle sheds.
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    Clinical Profile of Dengue Haemorrhagic Fever from Jan 2009 to Dec 2009 in and Around Aurangabad.
    (2011-06) Duthade, M M; Bhakare, J K; Damle, A S
    In present study 890 serum samples suspected of dengue fever on clinical grounds were received in department of Microbiology. Out of these 249 cases showed thrombocytopenia (platelet coun <1 lakh /cumm) and were subjected to rapid dengue serological test as well as IgM capture ELISA. 11(4%) cases were diagnosed as primary dengue infection (only IgM positive) by rapid dengue IgG/IgM bispot immunocomb test. There were 123(49%) cases with only IgG positive suggesting secondary/past dengue infection. Both IgM and IgG were seen in 24(10%) cases. Number of cases negative for both IgM and IgG were 91(37%). IgM positive cases were confirmed by IgM capture ELISA. Classical dengue fever (DF) was noted in 168 (67%) patients and dengue hemorrhagic fever (DHF) in 81(33%) cases. Common clinical presentations of DHF were fever 78(96%), body-ache 74(91%), arthralgia 74 (91%), retro-orbital pain 65(80%), abdominal pain 07(09%). Bleeding manifestation were in the form of petechiae, melena, epistaxis, hematuria, hemoptysis, hematemesis, bleeding gums and conjunctival hemorrhages. Out of 81 DHS patients 13(16%) patients had platelet count between 50,000 and 1 lakh. 68(84%) patients had platelet count below 50,000. Majority of these patients 47(58%) had platelet below 20000 and were IgG positive. Thrombocytopenia correlated well with bleeding manifestations in our patients. In an epidemic setting if the patients present with fever, vomiting, musculoskeletal pain and bleeding along with low platelet count a strong possibility of DHF/ DSS should be kept.
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    Comparison of HIV Antibody Detection by Conventional Method and Dried Tube Specimen : Stability and Validation Study for HIV Serology.
    (2011-06) Chopra, Shashi; Arora, Usha
    This study was carried out to compare HIV antibody detection by conventional method and serum dried in test tube and to check the stability of dried tube specimen (DTS) at ambient temperature. A total of 50 serum samples were tested for HIV antibodies, which were sent for testing in the state reference laboratory, by conventional method according to NACO guidelines. The same serum samples were dried in test tubes and then after elution with PBS again tested for HIV antibodies by same method and kits at 0 day and after 30 days. DTS eluted by PBS showed linear correlation to the serum samples. The antibodies in DTS were found to be stable at 37o c up to 30 days. This method is simple, sensitive and specific and can be used in resource limited settings embarking on scaling up of HIV testing.
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    Comparison of an Immuno-chromatographic Technique-based Kit (Malaria Card) with Microscopy for Rapid Diagnosis of Malaria in and Around Loni, Maharashtra.
    (2011-06) Gupta, Ashok K
    Although Plasmodium vivax is the major species responsible for malaria in most parts of India, P. falciparum infections have now increasingly been reported from some parts of India. A study was therefore, undertaken to compare immuno-chromatographic technique (ICT) based Malaria card test with microscopic examination of peripheral blood film in diagnosis of malaria in and around Loni, Maharashtra. A total of 143 (about 24%) samples of 590 febrile patients tested were detected positive for malarial infection- 74 samples for P. vivax (approx. 52%) and 69 for P. falciparum (approx. 48%). With Malaria card test, the sensitivity and specificity of 93.8% and 92.6% were recorded for P. vivax and 95.2% and 95.5% for P. falciparum, respectively. Therefore, the test is a valuable adjunct in an emergency for rapid diagnosis of malaria, though microscopy remains the mainstay for routine use in countries, like India.
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    To Study the Extent of Delay in Diagnosis and Treatment under DOTS.
    (2011-06) Rathi, Nitin; Jhamb, Rajat; Verma, Pushpender; Sarin, Rohit
    Present study was prospectively carried out at the 3 DOTS cum Microscopy Centres, associated with LRS Institute of Tuberculosis and Respiratory Disease. A pre-tested and pre-designed questionnaire was developed to study the objectives and the patients were interviewed with the questionnaire at beginning of treatment. Among the 311 patients who were included in the study , 158 patients consisted of different type of delay. In the study maximum delay was patient delay (43.08%) i.e. in DOTS maximum delay is due to patients reporting to the clinic after onset of symptoms. Diagnosis delay was found in only 7.34% cases, indicating that the diagnosis in DOTS is efficient. Treatment delay consisted of 22.5% among study among study population i.e. late initiation of treatment under DOTS is a major issue on which the system have to concentrate.
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    Pattern of Onychomycosis - A RIMS Study.
    (2011-06) Pukhrambam, Pratita Devi; Devi, Kh Ranjana; Singh, Ng Brajachand
    Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or non-dermatophytes moulds. In this study, 500 patients suspected of having onychomycosis reffered from the out patient department (OPD), Dermatology, Regional Institute of Medical Sciences(RIMS) Hospital Imphal Manipur during the period from January 2007 to December 2008 were processed in the Department of Microbiology RIMS. Nail clippings or scrapings depending on the variety of onychomycosis were collected with sterile blades under all aseptic measures. Specimens were put up for 10% KOH mount, fungal cultures on two sets of SDA (Sabouraud‘s dextrose agar) incorporated with antibiotics and lactophenol cotton blue preparation (LCB) from the cultures and examined microscopically. Slide cultures were also put up if necessary. Out of 500 samples processed, a total of 444(88.8%) were positive for the various fungi. The positive fungi were dermatophytes 258(58.1%), non-dermatophytes 139(31.3%), yeasts and yeast-like 17(3.8%) and mixed fungal isolates 30 (6.7%). Of the 230 males and 270 females studied,193(83.9%) males and 251(92.9%) females respectively were positive for various fungi causing onychomycosis. Maximum number of suspected cases were in the age group of 21-30 years.Among the dermatophytes, Trichophyton species (spp.) 250(50%) was the commonest isolate followed by Epidermophyton spp. 8(1.6%). Among the non-dermatophytes, Aspergillus spp. 70(14%) was the commonest followed by Penicillium spp. 24(4.8%), Acremonium spp. 9(1.8%), Fusarium spp. 8(1.6%), Curvularia spp. 7(1.4%), Alternaria spp. 5(1%), Scopulariopsis spp. 4(0.8%), Cladosporium spp. 4(0.8%), Nigrospora spp. 2(0.4%), Mucor spp. 1(0.2%), Paecilomyces spp. 1(0.2%), Pseudallescheria spp. (0.2%), Rhizopus spp. 1(0.2%), Verticillium spp. 1(0.2%), Exophiala jeanselmei 1(0.2%). Among the yeast and yeast-like i.e. Candida spp. 15, Geotrichum spp. 1, Rhodotorula spp. 1 were 17(3.8%), mixed fungal isolates 30(6.7%), respectively. Reports were given to the patient for follow up and treatment. Health awareness and suggestions were given for prevention and further spread of onychomycosis.
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    Rural-urban Population Movement, Community Context and Impact on DEC Fortified Salt Program to Eliminate Lymphatic Filariasis.
    (2011-06) Nandha, B; Krishnamoorthy, K
    Diethylcarbamazinecitrate (DEC) salt in conjunction with annual singledose mass drug administration (MDA) with DEC tablets can be considered as potential option to hasten the process of Lymphatic Filariasis (LF) elimination. Consumption of DEC tablet/salt by at least 80% of the endemic population is crucial in achieving elimination in five years. This study examines the determinants of rural-urban population movement and its implication on DEC fortified salt program to control LF. Data was collected through questionnaire from 150 each movers and non-movers from 10 randomly selected villages and also using Key informant (KI) interviews in Villupuram district in Tamil Nadu. Households with at least one family member engaged in movement at any point of time in the previous year, range from 24 - 43% in different villages. Knowledge on cause, control, ongoing LF elimination programs and compliance with DEC tablets (28.7%) and salt (30%) were significantly higher (p<0.05) among non-movers than movers (4.7% and 3.3%respectively). In order to achieve the goal of elimination of LF by 2020, measures need to be undertaken to ensure that the social mobilization activities and LF intervention programs need to cover the 24 - 43% of mobile population.
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    Rapid Detection of Viable M. tuberculosis Directly from Sputum by Reverse Transcriptase PCR Targeting 85B Gene.
    (2011-06) Ramasubban, Gayathri; Kulandai, Lily Therese; Sridhar, R; Durai, Kannan; Hajib, N Madhavan; Meenakshi, N
    This study was carried out to standardize reverse transcriptase PCR (RTPCR) targeting 85B gene for the rapid detection of viable Mycobacterium tuberculosis (M tuberculosis) from sputum specimens. 100 sputum samples from clinically suspected tuberculosis patients were included in the study. The sputum samples were collected in sterile diethyl pyrocarbonate (DEPC) treated containers and transported in ice to the laboratory within 2 hours to prevent degradation of RNA. The following microbiological analysis was performed on the sputum specimens: Ziehl Neelsen staining, Mycobacterial culture by BACTEC TB 460 reader and RT-PCR targeting 85B gene. Out of the 100 sputum samples, 40 sputum samples were Ziehl Neelsen stain positive, 58 sputum samples were culture and RT-PCR positive and 42 were culture and RT-PCR were negative. Among direct smear positive specimens, 3 specimens did not grow in culture and was RT-PCR negative indicating the non-viability of the acid-fast bacilli seen in the direct smear. The results of RT-PCR and culture against control group and clinically diagnosed tuberculosis patients were statistically significant by Chi square test (P<0.001). RT-PCR targeting 85B gene of M tuberculosis standardized in our laboratory for is a rapid, reliable and sensitive technique to detect the viable M tuberculosis directly from sputum specimens.
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    Salmonella enterica serotype Typhi from a Case of Empyema.
    (2011-03) Mahajan, Rakesh K; Kharbanda, Preeti; Ahuja, Sanjiv; Omprakash, B; Duggal, Nandini; Hans, Charoo
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    Risk Factors involved in the transmission of Dengue-DHF in some selected localities of Jaipur (Rajasthan), India.
    (2011-03) Katyal, Rakesh; Mathur, K K; Kumar, Kaushal; Das, B P; Saxena, V K; Lal, Shiv; Kumar, Sarita
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    Presentation and Complications among the Malaria Death Cases from Municipal Corporation Hospitals & Civil Hospital of Ahmedabad during the Year 2007.
    (2011-03) Vyas, Sheetal; Bhatt, Gneyaa; Gupta, Kinnari; Tiwari, Hemant
    The present study was carried out to have understanding of characterisation including symptoms, signs and laboratory parameters which are associated with fatality of malaria cases on arrival to hospital which may lead to early recognition and improved management. Information about deaths due to Malaria, as reported to malaria Department of Ahmedabad Municipal Corporation by municipal corporation hospitals and civil hospital from January 07 to December 07, was used to locate details of those deaths in respective hospitals by obtaining indoor case papers and death reports of those cases from Medical Record Section of respective hospitals and were analyzed by using appropriate statistical software. Total 57 malaria deaths occurred in the above mentioned 4 hospitals. Overall Case Fatality Rate was 3.03% for indoor malaria cases. Complete information could be obtained about 42 cases. Mean age of cases was 36.50 years. 45.23% of patients falling in the age group >=40yrs. There were 57.1% males and 42.9% females. 55 cases were positive for P. falciparum, 1 case for P. vivax and 1 case was having mixed infection. Average duration of Hospital stay was 2.87 days and average total duration of illness was 6.82 days. The most common presenting symptom was intermittent fever with vomiting & altered sensorium in 38.88% & most common complication was Acute Renal Failure in 45.2% of cases. Paired t-test was applied on the investigations carried out on the day of admission and those carried out on the day or before a day of death and found significant for the levels of Haemoglobin, Blood Urea & Serum Billirubin. Malaria still remains one of the important causes of admission and mortality. In view of changes in anti-malarial drug policy and introduction of costly artemisinin combination therapy accurate, rapid diagnostic tools are necessary to target treatment to people in need.