Changing scenario of malaria: a study at Calcutta

Area of Science:

• Clinical Tropical Medicine
• Infectious Diseases
• Parasitology

Background:

• Malaria's clinical presentation is evolving.
• Classic malaria symptoms are less common.
• This necessitates re-evaluation of diagnostic approaches.

Purpose of the Study:

• To investigate the changing clinical profiles of Plasmodium falciparum and Plasmodium vivax malaria.
• To compare the clinical manifestations between P. falciparum and P. vivax infections.
• To identify diagnostic challenges posed by atypical malaria presentations.

Main Methods:

• Clinical data from 60 P. falciparum and 165 P. vivax cases were analyzed.
• Species identification was confirmed by expert blood slide examination.
• Statistical significance was assessed for observed clinical differences.

Main Results:

• Classic fever paroxysms occurred in less than 50% of both P. falciparum and P. vivax cases.
• Jaundice and hepatomegaly were more frequent in P. falciparum malaria.
• Splenomegaly was significantly less common in P. vivax malaria (18.18%) compared to P. falciparum (40%).
• Severe P. falciparum malaria presented with complications like acute respiratory distress, renal impairment, convulsions, coma, DIC, and blackwater fever.
• Atypical presentations mimicked enteric fever and infective hepatitis.

Conclusions:

• Malaria's clinical spectrum has shifted, presenting diagnostic challenges.
• P. falciparum malaria is associated with a higher burden of severe complications.
• Distinguishing malaria from other febrile illnesses requires careful clinical and laboratory evaluation.