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Clinical profile and severity of Plasmodium vivax and falciparum malaria in hospitalized children from North India

 Department of Pediatrics, Teerthanker Mahaveer Medical College and Research Center (TMMC&RC), Moradabad, U.P., India

Correspondence Address:
Bablu Kumar Gaur,
Department of Pediatrics, Teerthanker Mahaveer Medical College and Research Center, Moradabad, U.P, Pincode-244001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-9062.331406

Background & objectives: Malaria is a most common parasitic infection in children and commonest cause of mortality by vector born disease in tropical countries. In this endemic region, there are limited published literature on clinical profile and severity of plasmodium vivax malaria in children. We highlight the clinical presentations and severity of malaria in children belongs to Uttar Pradesh (U.P), North India. Methods: This observational study was conducted in tertiary care hospital, Moradabad, Western Uttar Pradesh, India. Children(age 6months-18years) hospitalized from June 2019 to May 2020 with clinical picture consistent with malaria along with positive rapid malaria antigen test(RMAT) and/or positive peripheral blood smear for malaria were enrolled. All data pertaining to clinical profile and laboratory features were recorded. Results were analysed for significance using appropriate statistical tests for continuous and categorical data. Results: One hundred children were enrolled in this study, 59 cases had Plasmodium vivax (Pv) malaria, 33 cases had Plasmodium falciparum (Pf) malaria and 8 cases had mixed infections (both Pv and Pf). Among 59 children of Pv malaria, 44 (74%) had severe malaria and 15 (26%) had uncomplicated malaria. Severe malarial anemia (43.2%) followed by jaundice (36.4%), impaired renal function (21.6%) significant bleeding (18.9%), shock (18.9%) and prostration (16.2%) were the main severity parameters of malaria among these hospitalized children. Impaired renal function (P value=0.01) and unconsciousness (P value=0.02) were more frequent in Plasmodium falciparum cases, other severity parameters were not significant between vivax and falciparum species. Interpretation & conclusion: We conclude that a significant proportion of severe malaria was caused by plasmodium vivax in this region where both the species coexist. Plasmodium vivax malaria is now no more a benign entity in hospitalized children as it was around 10 year back. Severe malarial anaemia was the most common severity parameter found in both Plasmodium vivax and falciparum species. The clinical presentation and a change in the severity parameters in vivax malaria also indicate the recent shift in the disease severity from benign to fatal.

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