Comparison of clinico-laboratory profile and severity of malaria in Plasmodium vivax and Plasmodium falciparum at a tertiary care centre

Abstract

Introduction: Malaria is a vector-borne disease, a major public health concern. Due to changes in the clinical and epidemiological profile of malaria in our country P. vivax known to be benign has been reported to cause severe complications. This study is carried out to analyse the laboratory profile, clinical features and severity of disease in both P. vivax and P. falciparum infection. Materials and methods: This was the hospital-based cross-sectional type of prospective study. Blood sample was collected from clinically suspected malaria cases based on certain inclusion and exclusion criteria as per WHO guidelines. For the diagnosis of malaria, a conventional thick and thin peripheral smear and rapid diagnostic test (Advantage MALCARD) was done.
Result: A total number of 60 patients with malaria were included in the study. Out of 60 patients, 34 (56.66%) were males and 26 (43.33%) were females. The highest occurrence of malaria was in the age group 10-40 years. Among 60 patients, 40 (66.66%) were positive for P. vivax and 20 (33.33%) for P. falciparum. The most common presenting features in the patients were fever 60 (100%) followed by chills /rigor 58 (96.66%), headache 55 (91.66%), vomiting 50 (83.33%), splenomegaly 20 (33.33%). Severe anemia (Hb ˂5 gm %), leukopenia (TLC ˂4000 per cmm) was found more in P. vivax 25 (62.5%), 15 (37.5%), as compared to P. falciparum 8 (40%), 10 (50%), 20 (100%) respectively, while thrombocytopenia (˂50,000 per cmm) was observed in 20 (100%) P. falciparum as compared to 17 (42.5%) P. vivax. Out of 60 malaria patients, 14 (35%) of P. vivax and 8 (40%) of P. falciparum had severe malaria. Co-morbidities were present in these patients.
Conclusion: P. vivax is the major species, accounting for the majority of cases of malaria. P. vivax had more complications in our study. Association of co-morbidities in affecting the clinical outcome of malaria should be further explored.