To study the laboratory profile of severe malaria in a tertiary care centre of North India

  • Dr. Rahul Sood Department of Nephrology, Christian Medical College and Hospital, Ludhiana, Punjab, India
  • Dr. Timothy Rajamanickam Department of Nephrology, Christian Medical College and Hospital, Ludhiana, Punjab, India
  • Dr. Navjot Singh Department of Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India
Keywords: Laboratory parameters, Outcome, Mortality, Severe malaria

Abstract

Introduction: Malaria ranks third among the major infectious diseases in causing deaths- after pneumococcal acute respiratory infections and tuberculosis. It is expected that by the turn of the century malaria would be the number one infectious killer disease in the world. It is the most widely distributed and is responsible for up to 400 million infections every year. The aim of the study was to describe the laboratory parameters and their correlation with mortality in Malaria.

Methods: This was a one year retrospective and one and half year prospective study. All patients diagnosed to have Malaria were included in this study.

Results: Laboratory parameters were recorded carefully and the data was analyzed by the appropriate statistical methods. A total of 124 patients were studied 92 patients of Plasmodium vivax, 21 patients of Plasmodium falciparum and 11 patients of Mixed malaria. Complications observed were severe anemia(< 7 gm/dl), thrombocytopenia, renal dysfunction (S.creat > 1.2mg/dl), raised bilirubin > 3mg%, metabolic acidosis, and acute respiratory distress syndrome (ARDS). Thrombocytopenia and jaundice were the most frequent complications in the severe cases. 10/124 patients (8.06%) expired. 8/10 patients who expired had four or more organ dysfunction.

Conclusion: ARDS had the most significant correlation with mortality. Other significant factors contributing to death were jaundice, severe anemia and renal failure.

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References

Dash AP, Valecha N, Anvikar AR, Kumar A. Malaria in India: challenges and opportunities. J Biosci. 2008 Nov;33(4):583-92.doi: https://doi.org/10.1007/s12038-008-0076-x.

Kochar DK, Saxena V, Singh N, Kochar SK, Kumar SV, Das A. Plasmodium vivax malaria. Emerg Infect Dis. 2005 Jan;11(1):132-4.doi: https://doi.org/10.3201/eid1101.040519.

Makkar RP, Mukhopadhyay S, Monga A, Monga A, Gupta AK. Plasmodium vivax malaria presenting with severe thrombocytopenia. Braz J Infect Dis. 2002 Oct;6(5):263-5.doi: https://doi.org/10.1590/s1413-86702002000500008.

Rodríguez-Morales AJ, Sánchez E, Vargas M, Piccolo C, Colina R, Arria M, Franco-Paredes C. Occurrence of thrombocytopenia in Plasmodium vivax malaria. Clin Infect Dis. 2005 Jul 1;41(1):130-1. DOI: https://doi.org/10.1086/430837.

Fajardo L.F, Tallent C. Malarial parasites within human platelets. JAMA,1974; 229:1205-9.

Yamaguchi S, Kubota T, Yamagishi T, Okamoto K, Izumi T, et al. Severe thrombocytopenia suggesting immunological mechanisms in two cases of vivax malaria. Am J Hematol. 1997 Nov;56(3):183-6.doi: https://doi.org/10.1002/(sici)1096-8652(199711)56:3%3C183::aid-ajh9%3E3.0.co;2-u.

Nautiyal A, Singh S, Parameswar G, Disalle M. Hepatic dysfunction in a patient of P. vivax Malaria. Med Gen Med. 2005; 7(1): 8. PMCID: PMC1681376.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681376/.

Kochar DK, Singh P, Agarwal P, Kochar SK, Pokharna R, Sareen PK. Malarial hepatitis. J Assoc Physicians India. 2003 Nov;51:1069-72. https://pubmed.ncbi.nlm.nih.gov/15260391-malarial-hepatitis/.

Anand AC, Ramji C, Narula AS, Singh W. Malarial hepatitis: a heterogeneous syndrome?. Natl Med J India. 1992 Mar-Apr;5(2):59-62. https://pubmed.ncbi.nlm.nih.gov/1304265-malarial-hepatitis-a-heterogeneous-syndrome/.

Prakash J, Singh AK, Kumar NS, Saxena RK. Acute renal failure in Plasmodium vivax malaria. J Assoc Physicians India. 2003 Mar;51:265-7. https://pubmed.ncbi.nlm.nih.gov/12839348-acute-renal-failure-in-plasmodium-vivax-malaria/.

Maheshwari A, Singh AK, Sinha DK, Tripathi K, Prakash J.Spectrum of renal disease in malaria. J Indian Med Assoc. 2004 Mar;102(3):143, 146, 148 passim. https://pubmed.ncbi.nlm.nih.gov/15473274-spectrum-of-renal-disease-in-malaria/.

Lomar AV, Vidal JE, Lomar FP, Barbas CV, de Matos GJ, Boulos M. Acute respiratory distress syndrome due to vivax malaria: case report and literature review. Braz J Infect Dis. 2005 Oct;9(5):425-30. Epub 2006 Jan 6.doi: https://doi.org/10.1590/s1413-86702005000500011.

Kumar A, Valecha N, Jain T, Dash AP. Burden of malaria in India: retrospective and prospective view. Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):69-78. https://pubmed.ncbi.nlm.nih.gov/18165477-burden-of-malaria-in-india-retrospective-and-prospective-view/.

Nityanand, Agarwal HK. Hepatic and renal dysfunction. JAPI 1997; 45:

Agarwal A, Rath S, Shashiraj, 2005. Plasmodium vivax malaria presenting with severe thrombocytopenia. J Trop Pediatr. 2005 Apr ;51(2): 120–1.doi: https://doi.org/10.1093/tropej/fmh107.

Katira B, Shah I. Thrombocytopenia in Plasmodium vivax infected children. J Vector Borne Dis. 2006;43(3):147–49.

Weatherall DJ. The anaemia of malaria. In: McGregor I, ed. Wernsdorfer WH, eds. Malaria: Principles and Practice of Malariology. New York: Churchill Livingstone 1988; pp 735-51.

Anstey NM, Russell B, Yeo TW, Price RN. The pathophysiology of vivax malaria. Trends Parasitol. 2009;25(5):220–27.doi: https://doi.org/10.1016/j.pt.2009.02.003.

Haldar K, Mohandas N. Malaria, erythrocytic infection, and anemia. Hematology Am Soc Hematol Educ Program. 2009:87–93.doi: https://doi.org/10.1182/asheducation-2009.1.87.

Gupta A, Mathotra HS, Bombary P, Mittal PC, Sharma SK. Clinical pattem of complicated malaria in North West India. JAPI 1987.

Jain, M.A. and Kaur, M.B.: Comparative study of microscopic detection methods with hematological changes in malaria. Ind J PatholMicrobiol., 2005;48(4):464-7. https://pubmed.ncbi.nlm.nih.gov/16366095-comparative-study-of-microscopic-detection-methods-and-haematological-changes-in-malaria/.

Das BS. Renal failure in malaria. J Vector Borne Dis. 2008;45(2): 83–97. https://pubmed.ncbi.nlm.nih.gov/18592837-renal-failure-in-malaria/.

Prakash J, Singh AK, Gujrati S, Maheshwari A. Acute renal failure in malaria: changing trends. Indian J Nephrol. 2002;12(4):113–17. http://medind.nic.in/iav/t02/i4/iavt02i4p113.pdf.

Barsoum RS. Malarial acute renal failure. J Am Soc Nephrol. 2000; 11(11):2147–54. https://pubmed.ncbi.nlm.nih.gov/11053494-malarial-acute-renal-failure/.

Barsoum RS. Malarial nephropathies. Nephrol Dial Transplant . 1998; 13(6):1588–97.doi: https://doi.org/10.1093/ndt/13.6.1588.

Boonpucknavig V, Sitprija V. Renal disease in acute P. Falciparum. Kidney Int. 1979; 16: 44-52.doi: https://doi.org/10.1038/ki.1979.101.

David J, Shanbag P, More V. Plasmodium vivax malaria presenting as the nephrotic syndrome in an infant. Trop Doct. 2009 Apr;39(2):127-8. doi: https://doi.org/10.1258%2Ftd.2008.080288.

Sanghai SR, Shah I. Plasmodium vivax with acute glomerulonephritis in an 8-year old. J Vector Borne Dis . 2010;47(1):65–6. https://pubmed.ncbi.nlm.nih.gov/20231777-plasmodium-vivax-with-acute-glomerulonephritis-in-an-8-year-old/.

Bajiya HN, Kochar DK. Incidence and outcome of neurological sequelae in survivors of cerebral malaria. JAPI 1996; 44(10): 679- 81. https://pubmed.ncbi.nlm.nih.gov/9251338-incidence-and-outcome-of-neurological-sequelae-in-survivors-of-cerebral-malaria/.

Kochar DK, Das A, Kochar SK, Saxena V, Sirohi P, Garg S, Kochar A, Khatri MP, Gupta V. Severe Plasmodium vivax malaria: a report on serial cases from Bikaner in northwestern India. Am J Trop Med Hyg. 2009 Feb;80(2):194-8. https://pubmed.ncbi.nlm.nih.gov/19190212-severe-plasmodium-vivax-malaria-a-report-on-serial-cases-from-bikaner-in-northwestern-india/.

Bhalla A, Suri V, Singh V. Malarial hepatopathy. J Postgrad Med. 2006;52(4):315–20.doi: http://www.jpgmonline.com/text.asp?2006/52/4/315/28167.

Wilairatana P, Looareesuwan S, Vanijanonta S, Charoenlarp P, Wittayalertpanya S. Hepatic metabolism in severe falciparum malaria: caffeine clearance study. Ann Trop Med Parasitol. 1994 Feb;88(1):13-9.doi: https://doi.org/10.1080/00034983.1994.11812829.

Mishra SK,, S. Mohanty, B.S. Das, J.K. Patnail, S.K. Satpathy, D. Mohanty and T.K. Bose, Hepatic changes in P falciparum malaria, Indian J. Malariol. 29 (1992), pp. 167–71. https://pubmed.ncbi.nlm.nih.gov/1286732-hepatic-changes-in-p-falciparum-malaria/.

Anstey NM, Jacups SP, Cain T, et al. Pulmonary manifestations of uncomplicated falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis. 2002;185(9):1326–34.doi: https://doi.org/10.1086/339885.

Maguire GP, Handojo T, Pain MC, Kenangalem E, Price RN, Tjitra E, Anstey NM. Lung injury in uncomplicated and severe falciparum malaria: a longitudinal study in papua, Indonesia. J Infect Dis. 2005 Dec 1;192(11):1966-74. Epub 2005 Nov 1.doi: https://doi.org/10.1086/497697.

Mohan A, Sharma SK, Bollineni S. Acute lung injury and acute respiratory distress syndrome in malaria. J Vector Borne Dis. 2008;45(3):179–93.https://pubmed.ncbi.nlm.nih.gov/18807374-acute-lung-injury-and-acute-respiratory-distress-syndrome-in-malaria/.

Fein IA, Rackow EC, Shapiro L. Acute pulmonary edema in Plasmodium falciparum malaria. Am Rev Respir Dis. 1978;118(2):425–29.doi: https://doi.org/10.1164/arrd.1978.118.2.425.

Tanios MA, Kogelman L, McGovern B, Hassoun PM, 2001. Acute respiratory distress syndrome complicating Plasmodium vivax malaria. Crit Care Med 29: 665–67.doi: https://doi.org/10.1097/00003246-200103000-00037.

Mishra SK, Panigrahi P, Mishra R, Mohanty S. Prediction of outcome in adults with severe falciparum malaria: a new scoring system. Malar J. 2007 Feb 27;6:24.doi: https://doi.org/10.1186/1475-2875-6-24.

Tanios MA, Kogelman L, McGovern B, Hassoun PM. Acute respiratory distress syndrome complicating Plasmodium vivax malaria. Crit Care Med. 2001 Mar;29(3):665-7.

Mendis K, Sina BJ, Marchesini P, Carter R. The neglected burden of Plasmodium vivax malaria. Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):97-106.doi: https://doi.org/10.4269/ajtmh.2001.64.97.

Rogerson SJ, Carter R. Severe vivax malaria: newly recognised or rediscovered. PLoS Med. 2008 Jun 17;5(6):e136. doi: https://doi.org/10.1371/journal.pmed.0050136.

To study the laboratory profile of severe malaria in a tertiary care centre of North India
CITATION
DOI: 10.17511/ijmrr.2016.i10.30
Published: 2016-10-31
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Sood R, Timothy R, Singh N. To study the laboratory profile of severe malaria in a tertiary care centre of North India. Int J Med Res Rev [Internet]. 2016Oct.31 [cited 2024Nov.22];4(10):1907-14. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/734
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