Clinico-epidemiological features of malaria among children attending a tertiary care hospital: a two year study

Abstract

Background: Malaria caused by Plasmodium species and transmitted by Female anopheles mosquito, still remains as a major public health concern around the world. India is one of the major contributors of malaria cases in South East Asia. Malaria accounts for 205,000 deaths with 55,000 deaths occurring in early childhood. In endemic areas, children under 5 years are particularly susceptible to infection, illness and death. The present study was aimed to study the clinical, epidemiological profile of malaria cases among children (<12 years) attending a tertiary care hospital. We also assessed the complications associated with non-severe and severe malaria. Methods: The study was conducted at a tertiary care hospital for a period of two years and all children <12 years of age diagnosed with malaria were enrolled in the study. The demographic, clinical and laboratory parameters were observed and noted. Cases were categorized into severe and non-severe malaria based on the WHO guidelines.Results: A total of 2420 cases were observed and 250 cases of malaria were diagnosed, of which 136 were p. vivax mono infections, 82 falciparum malaria and 32 had evidence of mixed infections. Males were predominant in the study (58.8%) and 1-5 years was the common age group. Fever was the most common symptom (100%) in all cases and pallor, edema was common in falciparum malaria. jaundice was observed in 62% of mixed infections and altered sensorium in 43% of mixed infections. Severe malaria was observed almost equally in vivax and falciparum cases. Hyperparasitemia, cerebral malaria was common in falciparum cases than vivax. Thrombocytopenia, hypoglycemia and impaired consciousness were more common in mixed infections than falciparum and vivax cases.Conclusions: Present study finally concludes that there is a significant change in the trends of vivax malaria in this region where both species coexist. The spectrum of complications seen in vivax and falciparum follow a similar pattern, then mentioned earlier that complications are less frequently seen in vivax than falciparum malaria. Hence more number of studies is required to generate the differing patterns associated with vivax and compare them with different studies from geographic regions.