Plasmodium vivax malaria admissions and risk of mortality in a tertiary-care children's hospital in North India

Paediatr Int Child Health. 2012 Aug;32(3):152-7. doi: 10.1179/2046905512Y.0000000012.

Abstract

Background: In 2010, there was an increase in the severity of malaria admissions to Kalawati Saran Children's Hospital, New Delhi and this report describes the morbidity and mortality profile.

Method: A retrospective chart review of patients admitted with parasitologically confirmed malaria between January and December 2010.

Results: There were 156 cases: P. vivax 105 (67.3%), P. falciparum 39 (25%) and mixed infections 12 (7.7%). Thrombocytopenia (platelet count <150×10(9)/L) was present in 90 (85.7%) patients with P. vivax mono-infection. There were 91 (58.3%) patients with severe malaria: P. vivax mono-infection 46 (50.5%), P. falciparum mono-infection 35 (38.5%) and mixed 10 (11%). Severe anaemia and severe thrombocytopenia (platelet count <20×10(9)/L) were detected significantly more often in P. falciparum and P. vivax mono-infection, respectively. Complications including cerebral malaria, acute renal failure, shock, acute respiratory distress syndrome (ARDS) and multiple-organ dysfunction syndrome (MODS) were similar in both groups. The mortality rate of around 20% was similar in severe P. vivax and P. falciparum mono-infection. Risk of mortality in vivax malaria was highest in patients with ARDS followed by MODS and shock.

Conclusion: Increased morbidity owing to P. vivax malaria was observed and risk of mortality was highest in patients with ARDS and MODS.

MeSH terms

  • Adolescent
  • Anemia / epidemiology
  • Anemia / pathology
  • Child
  • Child, Preschool
  • Coinfection / epidemiology
  • Coinfection / mortality
  • Coinfection / pathology
  • Female
  • Hospitals, Pediatric
  • Humans
  • India / epidemiology
  • Infant
  • Malaria, Falciparum / complications
  • Malaria, Falciparum / epidemiology*
  • Malaria, Falciparum / mortality*
  • Malaria, Falciparum / pathology
  • Malaria, Vivax / complications
  • Malaria, Vivax / epidemiology*
  • Malaria, Vivax / mortality*
  • Malaria, Vivax / pathology
  • Male
  • Multiple Organ Failure / epidemiology
  • Multiple Organ Failure / mortality
  • Multiple Organ Failure / pathology
  • Respiratory Distress Syndrome, Adult / epidemiology
  • Respiratory Distress Syndrome, Adult / mortality
  • Respiratory Distress Syndrome, Adult / pathology
  • Risk Factors
  • Survival Analysis
  • Tertiary Care Centers
  • Thrombocytopenia / epidemiology
  • Thrombocytopenia / pathology