Study of Complications of Plasmodium Falciparum Cases Admitted In Medicine Department of A Tertiary Care Hospital, Ranchi, Jharkhand. (original) (raw)
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Clinical Spectrum of Severe Plasmodium falciparum Malaria in a Tertiary Care Centre of Eastern India
Introduction: Plasmodium falciparum malaria is one of the major public health problem presented with varied clinical severity. This study was carried out to observe the clinical spectrum of severe falciparum malaria in a tertiary health care centre. Methods: This study was undertaken in hospitalized adults with suspected severe malaria. Confirmation of falciparum infection was done by ICT/QBC and single-step-PCR. Diagnosis of severe malaria was done by WHO-guideline 2010. Original Research Article Purohit et al.; IJTDH, 12(4): 1-11, 2016; Article no.IJTDH.22387 2 Results: 450 adult cases with falciparum infection were studied. Maximum number of cases was from 15-25 years age group depicting the high exposure to malaria. In these patients, acute renal failure (ARF) was the most common (36.2%) complication followed by cerebral malaria (35.3%), jaundice (27.8%), hepatic dysfunction (21.8%), respiratory distress (18.4%), severe malarial anemia (15.8%), thrombocytopenia (15.1%), and hypoglycemia (9.3%). Mortality was found in 6.0% of cases. Cerebral involvement and ARF were the common cause of death in these patients. Conclusion: ARF is the most common type of clinical severity followed by cerebral malaria in adults and both are equally responsible for death along with other complications. Looking into the matter of varied clinical severity, accurate diagnosis, effective anti-malarial treatment along with supportive therapy is necessary to triumph over this deadly severe falciparum malaria.
Journal of Clinical and Scientific Research, 2017
Background: Sparse published data are available regarding clinical presentation and complications of falciparum malaria from Andhra Pradesh state. Methods: In this prospective, observational study conducted during the period November 2012 to June 2014 at our teaching hospital in Kuppam, Andhra Pradesh, adult patients (n=96) admitted with fever confirmed to be suffering from falciparum malaria based on peripheral blood smear examination and / or malaria antigen test positive by rapid diagnostic test were studied. The clinical presentation and various complications of falciparum malaria were documented. Results: The male to female ratio was 2:1. Majority of the patients (70%) were in the age group 26-60 years. Fever was present in all cases. Splenomegaly (66%) was the most common physical sign followed by pallor (31%) and icterus (22%). Anaemia (51%), was the most common complication, followed by cerebral malaria (33.3%), acute respiratory distress syndrome (ARDS) (32.3%), acute kidney injury (AKI) (29.2%), and jaundice (25%). Majority of the patients presented with multiple complications (73%) than single complication (27%). Artemesinin-based combination therapy was administered to 72 of the 96 patients of whom 43 patients recovered. Quinine therapy was given to 14 patients of whom 10 recovered. Quinine plus ACT combination therapy was given to 10 patients and 7 recovered. seven of the 96 patients died; and 29 out of 96 patients were taken home against medical advice. Overall 36/96 (37.5%) patients had a poor outcome. All 7 patients who expired had multiple complications. Mortality was higher in patients who had co-existent AKI, hypotension and cerebral malaria. Conclusion: Early identification of high risk cases and institution of prompt treatment can reduce the mortality rate in falciparum malaria.
International Journal of Advances in Medicine, 2016
Malaria continues to be one of the important public health problems in India. As per World Health Organization report 2015, South East Asian Region bears the second largest burden of malaria (10%), only being next to African region (88%).Malaria caused 214 million infections and 438000 deaths worldwide, most of them occurred in the Africa region (90%) followed by SEA Region (7%). 1 Among Southeast Asia region, India shares two-thirds of the burden (66%) followed by Myanmar (18%) and Indonesia (10%). 2 The malaria situation remains a major problem in certain states and geographical pockets. The majority of malaria cases and deaths in India are being reported from Orissa, Rajasthan, Jharkhand, Chhattisgarh, Madhya Pradesh and the Seven North Eastern states. 3 Malaria is caused by protozoan parasite of genus plasmodium. Five species of the plasmodium P. Falciparum, P. Vivax, P. Ovale, P. Malariae and P. Knowlesi cause malaria in humans. Infection is initiated when sporozoites from the salivary glands of a female anopheles mosquito are inoculated during a blood meal into the human blood stream. 4 The common clinical manifestation are fever with chills and rigors, headache, vomiting, jaundice and common sign being splenomegaly, pallor, and icterus. 13,22-23 Hematological abnormality which is most commonly seen in malaria is thrombocytopenia followed by anemia. Both are seen ABSTRACT Background: Malaria continues to be one of the important public health problems in India. As per World Health Organization report 2015, South East Asian Region bears the second largest burden of malaria (10%), only being next to African region (88%).The present study is aimed at to study clinical profile and complications, in a tertiary care hospital. Methods: A total of 100 cases were included in the study that admitted at NMCH, Kota and identified positive for malaria parasites on peripheral smear examination with conventional microscopy and / or by rapid diagnostic test. Results: predominant symptoms were fever (100%), vomiting (52%), headache (34%), myalgia (28%) and jaundice (27%) and signs were splenomegaly (75%), pallor (57%), icterus (28%), hepato-splenomegaly (19%), and hepatomegaly (04%). In this study, 82% patients suffered from uncomplicated malaria and 18% from complicated malaria. Conclusions: Malaria is responsible for major health concern in Southeastern region of Rajasthan and is found to affect comparatively the younger adult population. P. Vivax was the major parasite type causing malaria and most of the complications were due to P. falciparum.
Study of clinical profile of falciparum malaria in a tertiary referral centre in Central India
The Journal of the Association of Physicians of India, 2012
Malaria, a disease with protean manifestations is endemic in India with an estimated 70-100 million cases each year. Of these 45-50% are plasmodium falciparum. The present study is aimed at to study clinical features, complications, response to treatment and outcome in a tertiary care hospital. This hospital based cross sectional study was done on 80 confirmed cases of falciparum malaria (either by peripheral smear or rapid diagnostic test) more than 12 years of age admitted in NKPSIMS and LMH from December 2009 to December 2010.A case sheet proforma was prepared and data (demographic profile, clinical feature, investigation, treatment, and complication) from all indoor patients was collected and analyzed. Out of 80 patients, 60 (75%) were males and 20 (25%) were females. Most of the patients were between the age group 21-40 years with the highest incidence between the age group of 21-30. The numbers of admissions due to malaria increased from June onward with maximum number of case...
The changing spectrum of severe falciparum malaria: a clinical study from Bikaner (northwest India)
Journal of vector borne diseases, 2006
Recently there were reports from all over India about changing spectrum of clinical presentation of severe malaria. The present study was planned to study the same in the northwest India. This prospective study was conducted on patients of severe malaria admitted in a classified malaria ward of a tertiary care hospital in Bikaner, Rajasthan (northwest India) during 1994 and 2001. It included adult patients of both sexes belonging to all age groups. The diagnosis of Plasmodium falciparum was confirmed by demonstrating asexual form of parasites in peripheral blood smear. All patients were treated with i.v./oral quinine. The specific complications were treated by standard WHO protocol. The data for individual complications for both the years were analysed by applying chi-square test. In a prospective study in 1994 the spectrum of complication was dominated by cerebral malaria (25.75%) followed by jaundice (11.47%), bleeding tendencies (9.59%), severe anaemia (5.83%), shock (5.26%), Acu...
The changing clinical spectrum of Malaria: a clinical study from Bundelkhand
IOSR Journal of Dental and Medical Sciences, 2014
Objective: To find out clinical and laboratory findings in acute malaria caused by various plasmodium species. Methods: This was a prospective study which was carried out in the department of medicine at MLB Medical College ,Jhansi from May 2012 to September 2013.In this prospective study ,401 patients of malaria were enrolled who met both inclusion and exclusion criteria. Frequencies of alterations in clinical and laboratory parameters were determined in various plasmodium species. Results: Out of 401 patients, 194 were Plasmodium falciparum, 185 were P.vivax and 22 were mixed infection. Fever (97.5%), chills and rigors (84.7%) were the most common complaint in all three varieties of plasmodium infection. Pallor (78.3%) and splenomegaly (56.6%) were often detected in individuals with malaria. Thrombocytopenia (52.8%) was most common laboratory abnormalities detected in various plasmodium species. Jaundice and anemia were more common in P.falciparum and mixed infection as compared to P.vivax Conclusion: Malaria must be considered as leading differential diagnosis in an acutely febrile patient with one or more of abnormalities like splenomegaly, fall in blood counts or rise in bilirubin etc. Fever with chills and rigors, pallor, splenomegaly and thrombocytopenia were most common manifestation in malaria.
Study About Poor Prognosis and Mortality Rate of P.Falciparum Malaria Infection in Children in Bihar
IOSR Journals , 2019
Background: The epidemiology of malaria in children is difficult to assess as most of clinical symptoms are non-specific and most of the cases occur in settings where no routine testing is available. The infection with the species Plasmodium falciparum is one of the leading causes of child death from infectious diseases worldwide. Malaria, a non-fatal disease if detected promptly and treated properly, still causes many deaths in malaria-endemic countries with limited healthcare facilities. Objective: Study about poor prognosis and mortality rate of p.falciparum malaria infection in children in Bihar. Materials & Methods: The study was carried out between Oct 2005 and Sept 2006 in the Department of Paediatrics PMCH Patna. All children (up to 18 yrs of age with fever of short duration visited to hospital either in OPD or indoor without any documented pre-existing systemic illness were included in this study. The cases for present study were selected on random basis amongst the case of malaria as per following protocol. Primary pool patients of all age groups, religion, presented with fever of short duration without any documented pre-existing illness and tested for malaria parasite via PBS (thick & thin smear) and rapid antigen test. Secondary pool cases from primary pool with definite diagnosis of p. falciparum malaria, were further divided into uncomplicated & complicated group according to WHO criteria 2000. Results: About 150 cases were positive for p.falciparum malaria. Out of 150 cases under study 65 (43.33%) were complicated and 85 (56.67%) were uncomplicated cases of p. falciparum malaria. Incidence of p. falciparum malaria among febrile children was 84%. Incidence of p. falciparum was 16% of total malaria cases. Cerebral anemia was commonest complication (29.23%) of p. falciparum infection followed by jaundice (29.2%), hypoglycaemia (29.2%), and severe anemia (24.6%). MODS (21.33%), ARDS (3.07%), shock (3.07%), DIC (1.5%), acidosis (4.61%), ARF (6.15%) were uncommon complications. Number of mortality in complicated malaria was 8 which were 12.3% of complicated malaria and 5.33% of total p.falciparum malaria. Incidence of mortality rate in cerebral malaria was 21.05% which was 50% of total death, in severe anemia 6.25%, in ARF 50%, in shock 50%, pulmonary edema 100% and in MODS 35.71% respectively. Conclusion: Children who were suffering with pulmonary edema, shock, ARF, and cerebral malaria have poor prognosis because mortality rate in the above complications is very high.
Epidemiological Profile of Malaria Cases admitted to a Tertiary Care Centre of Odisha
2015
A record based study was conducted in a tertiary care centre of Odisha to know the socio-demographic and other epidemiological factors associated with the case fatality among the inpatient malaria cases admitted to medicine indoor. Total 557 laboratory confirmed malaria cases were studied. Majority of them (36%) belonged to 21-30 years age group and 85% were males. About 87% cases were from rural areas. More than 90% malaria cases were infected either by Plasmodium falciparum or by both P. falciparum and P. vivax. Among the complicated malaria cases, the most common complication was cerebral malaria (38%) followed by acute renal failure (ARF) (24%), hepatopathy (23%), both ARF and hepatopathy (11%), shock (4%) and algid malaria (1%). The overall case fatality rate was 10.6%. In complicated malaria, case fatality was significantly higher among female cases than male cases (35% vs 12%). Also the age specific case fatality rates in both the categories i.e. uncomplicated and complicated...
Clinical profile of severe malaria: study from a tertiary care center in north India
One hundred and sixty patients having clinical features of severe malaria reported during monsoon season-August-October 2010 at this tertiary care center of north India. Of these 110 (68.75 %) had Plasmodium vivax infection, 30 (18.75 %) were infected with P. falciparum and 20 (12.5 %) had co-infection due to P. vivax and P. falciparum. The diagnosis was made using Rapid Card Test and was confirmed by peripheral smear examination of thick and thin films. Several complications such as acute kidney injury, jaundice, severe anemia, metabolic acidosis, shock, hyperpyrexia, hypoglycemia, generalized tonicclonic convulsions etc. were found to be more prevalent in patients with P. vivax infection. These symptoms were until recently known to be associated with falciparum malaria.
Journal of Evidence Based Medicine and Healthcare, 2018
BACKGROUND Traditionally plasmodium vivax has been considered to be the cause for benign malaria and plasmodium falciparum to cause severe malaria. The incidence of P. vivax malaria in Rohtas district (Bihar) and neighbouring districts is quite high and P. vivax cases with severe complication are coming to NMCH, Rohtas for treatment. Thus, the present study was conducted to find out morbidity and mortality of P. vivax and P. falciparum malaria.