Complications of vivax malaria in Uttarakhand, India.

ABSTRACT

Background: Malaria is an important cause of mortality and morbidity in India. Many recent studies have shown that vivax malaria which was once thought to be a benign condition has emerged in a more virulent form causing many cases of severe malaria and life threatening complications. There is paucity of data on this topic from this region. Objective: The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from vivax malaria. The study has also tried to find out severe malaria associated with P. vivax infection. Methods: The study was performed at SGRR Institute of Medical & Health Sciences, Dehradun, which is a tertiary care hospital of Uttarakhand. The study period was of two years, from September 2011 to August 2013. Patients of 18 years of age or above it who were smear positive or antigen positive were included in the study. All such patients who were admitted in the hospital underwent detailed clinical examination and investigation. Results: Plasmodium vivax infection was identified in 140 patients. Splenomegaly, hepatomegaly, and hepatosplenomegaly, were common findings. Renal, hepatic and cerebral dysfunctions were noted. Severe malaria was observed in 63(45.0%). Thrombocytopenia was the commonest hematological abnormality. Mortality was seen in 9(6.4%) patients. Cerebral malaria, shock and ARDS were associated with high mortality and poor outcome. Conclusion: Vivax malaria may cause life threatening complications. The complications of vivax malaria are similar to those which have been traditionally described with falciparum malaria.