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Changing profile of severe malaria in north Indian children

Dinesh Yadav1, Jagdish Chandra, Satinder Aneja

  • 1Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India. dineshmamc@gmail.com

Indian Journal of Pediatrics
|November 18, 2011
PubMed

Insights

Severe Plasmodium vivax malaria is an emerging threat in North Indian children, causing significant morbidity and mortality. This challenges the view of Pv malaria as a benign illness, necessitating further research.

Area of Science:

  • Pediatric infectious diseases
  • Malariology
  • Tropical medicine

Background:

  • Plasmodium vivax (Pv) is often considered a less virulent malaria parasite compared to Plasmodium falciparum (Pf).
  • Understanding the clinical profile and morbidity associated with severe malaria in children is crucial for effective public health strategies.

Purpose of the Study:

  • To investigate the clinical characteristics of severe malaria in North Indian children.
  • To determine the contribution of Plasmodium vivax infection to overall malarial morbidity and mortality.

Main Methods:

  • A retrospective analysis of clinical, biochemical, and hematological data of children hospitalized with severe malaria over three years.
  • Diagnosis of malaria was confirmed by peripheral blood smear microscopy and/or antigen testing.

Main Results:

  • Plasmodium vivax accounted for the majority of severe malaria cases (55.3%), followed by Plasmodium falciparum (33.3%) and mixed infections (11.4%).
  • While Plasmodium falciparum was associated with higher rates of cerebral malaria, anemia, and shock, Plasmodium vivax infections frequently led to hepatic, renal, respiratory, and bleeding complications.
  • Mortality rates were highest in mixed infections (11.1%), followed by Pf (7.6%) and Pv (3%) groups.

Conclusions:

  • Severe and fatal Plasmodium vivax malaria is an emerging concern, contradicting the historical perception of Pv as a non-life-threatening infection.
  • Further clinical and molecular research is essential to elucidate the mechanisms behind the emergence of severe malaria in Plasmodium vivax mono-infections.
Abstract

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