Prospective Study Of The Clinical Profile Of Hospitalized Patients Of Malaria
Prospective Study Of The Clinical Profile Of Hospitalized Patients Of Malaria
DOI:
https://doi.org/10.70284/njirm.v4i4.2213Keywords:
Malaria, Plasmodium falciparum, Plasmodium vivaxAbstract
Background & Objectives: To study the clinical profile of hospitalised patients of malaria aged 15-60 years. Methods: This was a prospective analysis of patients suffering from malaria diagnosed by malaria serology and/or peripheral smear. The mode of presentation, clinical course, treatment history, laboratory investigations and complications were recorded and the data statistically analyzed.Results: P. vivax was the most common (80.39%) plasmodium species, the rest (19.61%) being P. falciparum. The mortality rate was 6.54%. A fall in hemoglobin (p=0.005) and platelet count (p=0.040) was observed in the patients who expired. There was an improvement in the final platelet counts in both the groups (p=0.00052). The mean total bilirubin at admission was higher in P. falciparum group than P. vivax group (p = 0.00789). Renal failure was observed in 16.34% patients. The mean systolic and diastolic blood pressure in patients who expired was lower than patients who were discharged (p=0.007, 0.001). The mean heart rate was higher (109.40) in patients who expired (p = 0.002). Conclusion: Factors associated with poor prognosis in malaria are moderate grade fever, hypotension, tachycardia, anaemia, thrombocytopenia, hyperbilirubinemia, high transaminase and renal failure. A high clinical suspicion, early diagnosis and treatment is recommended in highly prone areas
References
2. Kakar A, Bhoi S, Prakash V and Kakar S. Profound thrombocytopenia in Plasmodium vivax malaria. Diagn Microbial Infect Dis. 1999; 35: 243-44.
3. Krishnan A and Karnad DR. Severe Falciparum Malaria: An important cause of multiple organ failure in Indian intensive care unit patients. Crit Care Med. 2003; 31: 2278-84.
4. Murthy GL, Sahay RK, Srinivasan VR, Upadhaya AC, Shantaram V and Gayatri K. Clinical profileof falciparum Malaria in a tertiary care hospital. J Indian Med Assoc. 2000; 98(4): 160-2, 169.
5. National Anti Malaria Program. New Delhi: Directorate of NAMP, Ministry of Health and Family Welfare 2002.
6. Koh KH, Chew PH and Kiyu A. A Retrospective Study of Malaria Infections in an Intensive Care Unit of a General Hospital in Malaysia. Singapore Med J. 2004; Vol 45(1): 28-36.
7. Mehta KS, Halankar AR, Makwana PD, Torane PP, SAtija PS and Shah VB. Severe acute renal failure in malaria. J Postgrad Med. 2001 Jan-Mar; 47(1):24-6.
8. Malhotra OP, Bhatia SJC and Saxena R. A study of clinical and hematological manifestations of Malaria. Indian Journal of Haematology and Blood Transfusion. 1997; 15: 400.
9. Mehta SR, Naidu G, Chander V and Singh IP. Falciparum malaria present day problem - an experience with 425 cases. J Assoc Physicians India. 1989; 37: 264-7.
10. Ejezie GC and Ezedinachi EN. Malaria parasite density and body temperature in children under 10 years of age in Calabar, Nigeria. Trop Geogr Med. 1992 Jan; 44(1-2): 97-101.
11. Abisheganadan J, Rajasoorya C, Tan PK, Ang P and Chew LS. Malaria: an audit of 56 cases admitted to a hospital: Singapore Med J. 1996; 37: 153-156.
12. Murthy: Malarial hepatitis - Does such a Clinical entity exist: Journal Assoc Physicians India. Vol. 47; No. 1:27.
13. Sharma SK, Das RK, Das BK, Das PK. Haematological and coagulation profile in acute falciparum malaria. J Assoc Physicians India. 1992; 40: 581-3.
14. Kehinde MO, Ohwovoriole AE, Ekanem OJ, Odusote K, Abegunde AT and Adeniji A. Effect of acute uncomplicated malaria on platelet counts. Niger Postgrad Med J. 2005 Mar; 12(1): 10-13.
15. Looareesuwan S, Davis JG, Allen DL, Lee SH, Bunnag D and White NJ. Thrombocytopenia in malaria. Southeast Asian J Trop Med Public Health. 1992; 23: 44-50.
16. Jadhav UM, Patkar VS and Kadam NN. Thrombocytopenia in malaria-Correlation with type and severity of malaria. J Assoc Physicians India. 2004; 52: 615-18.
17. Horstmann RD: Malaria Induced thrombocytopenia; BLUT. 1981; 42(3); 157.
18. Ignatius CM, Emeka EN and Blessing NE. Effect of Malaria parasitaemia on Liver Enzyme Tests. International Journal of Tropical Medicine year. 2008, 3(3): 49-52.
19. Kanodia KV, Shah PR, Vanikar AV, Kasat P, Gumber M and Trivedi HL. Malaria induced acute renal failure: A single center experience. Saudi J Kidney Dis Transpl. 2010; 21:1088-91.
