Severe Vivax Malaria: A Study on its Clinical Manifestations, Risk Factors, Outcome and Therapeutic Efficacy of Artesunate
Manoj Kumar Mohapatra
Laxmi Kanta Dash
Dept. of Medicine, V.S.S. Medical College, Burla, Sambalpur, Odisha Qr.No.C/1, Doctors Colony, Burla, Sambalpur, Odisha, 768017
International Journal of Clinical Case Reports, 2013, Vol. 3, No. 3 doi: 10.5376/ijccr.2013.03.0003
Received: 10 Feb., 2013 Accepted: 26 Feb., 2013 Published: 08 Mar., 2013
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Severe vivax malaria has been emerged as a newly recognised entity in different parts of the globe. This study was undertaken because there is lack of research on different clinical and therapeutic aspects of the disease. Methods: It comprised of two parallel sub-studies. Sub-study-1 evaluated the clinical manifestations, risk factors, and outcome. Sub-study-2 investigated the therapeutic efficacy of Artesunate. P. vivax malaria was diagnosed from Giemsa stained peripheral blood smear and ICT test. Severe malaria was diagnosed according to WHO criteria. Organ dysfunction was defined and severity of complication was assessed by Malaria Severity Score. 300 adult patients of vivax malaria were enrolled in the study. Of them 60 (20.0%) had severe malaria. Single and multiple complication was found in 46 (76.7%) and 14 (23.3%) cases. Jaundice and haematological complication were the most common complications (n=24, 40.0% each) followed by cerebral complication (n=14, 23.3%). Among the multiple complications, the constellation of jaundice, cerebral malaria, and renal failure was (6.6%) common. The risk factors for developing severe malaria are low BMI (<20.0) , high parasite count (>8 000/μL), age more than 40 years , fever to treatment interval (>4.0 days), bad treatment history, associated infection, and co-morbid conditions. Inj.artesunate was effective with adequate efficacy in 96.6% cases. The outcome was good without any death. P.vivax malaria can complicate with severe malaria with different risk factors. Artesunate is effective with good outcome.
Severe vivax malaria; Malaria severity score; Risk factors; Co-morbidity
International Journal of Clinical Case Reports
• Volume 3