Clinical and Epidemiological Profiles of Severe Malaria in Children from Delhi, India.
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Date
2012-03
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Abstract
Plasmodium vivax is traditionally known to cause benign tertian malaria, although recent reports suggest
that P. vivax can also cause severe life-threatening disease analogous to severe infection due to P. falciparum.
There are limited published data on the clinical and epidemiological profiles of children suffering from
‘severe malaria’ in an urban setting of India. To assess the clinical and epidemiological profiles of children
with severe malaria, a prospective study was carried out during June 2008–December 2008 in the Department
of Pediatrics, Guru Teg Bahadur Hospital, a tertiary hospital located in East Delhi, India. Data on
children aged ≤12 years, diagnosed with severe malaria, were analyzed for their demographic, clinical and
laboratory parameters. All patients were categorized and treated as per the guidelines of the World Health
Organization. In total, 1,680 children were screened for malaria at the paediatric outpatient and casualty
facilities of the hospital. Thirty-eight children tested positive for malaria on peripheral smear examination
(2.26% slide positivity rate). Of these, 27 (71%) were admitted and categorized as severe malaria as per
the definition of the WHO while another 11 (29%) received treatment on outpatient basis. Most (24/27;
88.8%) cases of severe malaria (n=27) were infected with P. vivax. Among the cases of severe malaria caused
by Plasmodium vivax (n=24), 12 (50%) presented with altered sensorium (cerebral malaria), seven (29.1%)
had severe anaemia (haemoglobin <5 g/dL), and 17 (70.8%) had thrombocytopaenia, of which two had
spontaneous bleeding (epistaxis). Cases of severe vivax malaria are clinically indistinguishable from severe
falciparum malaria. Our study demonstrated that majority (88.8%) of severe malaria cases in children from
Delhi and adjoining districts of Uttar Pradesh were due to P. vivax-associated infection. P. vivax should, thus,
be regarded as an important causative agent for severe malaria in children.
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Keywords
Child, Malaria, Plasmodium vivax, Prospective studies, India
Citation
Kaushik Jaya Shankar, Gomber Sunil, Dewan Pooja. Clinical and Epidemiological Profiles of Severe Malaria in Children from Delhi, India. Journal of Health, Population and Nutrition. 2012 Mar; 30(1): 113-116.