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Plasmodium vivax malaria--is it really benign?

Tarachand Saini, Maniram Kumhar, H C Barjartya

Journal of the Indian Medical Association

|June 28, 2014

Summary

Plasmodium vivax malaria is increasingly causing severe complications and hospitalizations, challenging the notion that it is a mild infection. This study highlights the significant morbidity and mortality associated with P. vivax, necessitating urgent clinical attention.

Area of Science:

Tropical Medicine
Infectious Diseases
Malariology

Background:

Plasmodium vivax malaria was traditionally considered mild and non-life-threatening.
Recent trends indicate a rise in hospitalization rates and severe complications associated with P. vivax infections.

Purpose of the Study:

To evaluate the severity and complicated presentations of Plasmodium vivax malaria.
To assess the morbidity and mortality patterns in P. vivax malaria patients.

Main Methods:

A hospital-based study conducted at Jawahar Lal Nehru Hospital, Ajmer, India.
Inclusion of 102 indoor patients with isolated P. vivax malaria.
Treatment of severe and complicated P. vivax malaria cases following protocols for severe P. falciparum malaria.

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Main Results:

Significant complications observed include hepatomegaly (21.57%), thrombocytopenia (18.63%), and acute renal failure (11.76%).
Other severe manifestations included severe anemia (8.82%), leucopenia (5.88%), and electrolyte disturbances (5.88%).
Rare but critical complications like cerebral malaria (2.94%) and multi-organ dysfunction (1.96%) were also documented.

Conclusions:

Plasmodium vivax malaria can lead to significant morbidity and mortality, comparable to Plasmodium falciparum malaria.
The findings challenge the historical view of P. vivax as a benign infection, underscoring the need for vigilant management and hospitalization when severe complications arise.