Plasmodium Falciparum Versus Plasmodium Vivax: Which Is a Lesser Evil?

Authors

  • Chirag C Rathod GMERS Medical College, Gotri, vadodara
  • Shubhangi V Deshpande GMERS Medical College, Gotri, vadodara
  • Himanshu M Rana GMERS Medical College, Gotri, vadodara
  • Varsha Y Godbole GMERS Medical College, Gotri, vadodara
  • Amul Patel GMERS Medical College, Gotri, vadodara
  • Vaibhav Patel GMERS Medical College, Gotri, vadodara
  • Dimple Darad GMERS Medical College, Gotri, vadodara
  • Maulik Panchal B.J. Medical College, Ahmedabad

Keywords:

P. falciparum malaria, P. vivax malaria, Leucopenia, Thrombocytopenia, Clinico-pathological profile

Abstract

Background: With changing spectrum, different grades of biochemical & haematological changes generally found to be more severe with p. falciparum, now frequently seen with p. vivax. Present study intends to find species specific differences in diseases progression & complications.

Methodology: A retrospective study of Malaria-patients admitted at GMERS Medical College & Hospital, Vadodara from january-2011to december-2011 was done. p. falciparum, P. Vivax were diagnosed by demonstrating asexual forms of parasites in peripheral blood smear, haematological & biochemical tests were analyzed.

Results: Out of 1093 cases, 781 were slide positive, remaining 312 were treated on clinical-ground .Of 781 cases, 443 (56%) p. falciparum, 327 (42%) P. Vivax and 11(2%) were mixed Infection. Male to female ratio was 1.8:1&0.8:1 in p. falciparum & P. vivax, respectively. Fever, Prodroms, GI symptoms, Liver -dysfunction (51%vs47%), Renal- dysfunction (52%vs48%) were equally frequent; whereas Hemolysis, Bleeding tendency, Breathlessness and altered sensorium were more in p. falciparum. Anemia (56%), Thrombocytopenia (60%), Pancytopenia (54%), Hemolysis (65%) was more frequent in p. falciparum. Leucopenia (54%) was more frequent in p. Vivax.

Conclusion: In contrast to earlier studies, which have proven p. falciparum to be more fatal & complicated, it was noted in present study that P. Vivax species was frequent cause of overall slide-positive cases causing complications head to head with p. falciparum. Anemia, Hepato-renal dysfunctions were equally frequent, nonfatal leucopenia more in p. Vivax, while hemolysis and thrombocytopenia was more in p. falciparum. If ignored complications can alter clinical course & be equally fatal in p. vivax malaria. Hence p. vivax can no more be considered as benign infection and can be equally lethal.

References

WHO, World Malaria Report, 2008. Geneva, Switzerland.

Breman, JG, Plowe, C. A malaria vaccine for control: More progress. J Infect Dis 2009; 200:317.

Snow RW, Guerra CA, Noor AM, et al. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 2005; 434:214.

Price RN, Tjitra E, and Guerra CA, et al. Vivax malaria: neglected and not benign. Am J Trop Med Hyg 2007; 77:79.

Breman JG. Eradicating malaria.SciProg 2009; 92:1.

Wilson ME, Weld LH, Boggild A, et al. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis 2007; 44:1560.

Svenson JE, MacLean JD, Gyorkos TW, Keystone J. Imported malaria.Clinical presentation and examination of symptomatic travelers. Arch Intern Med 1995; 155:861.

White, NJ, Breman, JG. Malaria. In Harrisons Principles of Internal Medicine, 17th ed., D Kasper, E Braunwald, AS Fauci, SL Hauser, DL Longo, JL Jameson, Eds, McGraw Hill Co., New York, 2008:1280-1294.

WHO guidelines for the treatment of malaria. Geneva, World Health Organization, 2010. http://whqlibdoc.who.int/publications/2010/9789241547925_eng.pdf.

Devarbhavi H, Alvares JF, Kumar KS. Severe falciparum malaria simulating fulminant hepatic failure. Mayo ClinProc 2005; 80:355.

FIELD JW. Blood examination and prognosis in acute falciparum malaria. Trans R Soc Trop Med Hyg 1949; 43:33.

Steketee RW, Nahlen BL, Parise ME, Menendez C. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg 2001; 64:28.

Barsoum RS. Malarial acute renal failure. J Am SocNephrol 2000; 11:2147.

Tamez PA, Liu H, Fernandez-Pol S, et al. Stage-specific susceptibility of human erythroblasts to Plasmodium falciparum malaria infection. Blood 2009; 114:3652.

Tjitra, E, Warikar, N, Ebsworth, EP, et al. Major Burden of P. vivax infection in Papua, Indonesia; A Region with High levels of Chloroquine Resistance. In: XVIe International Congress for Tropical Medicine and Malaria. Queguiner, P, Saliou, P (Eds), Marseille 2005. p. 315.

Rodríguez-Morales AJ, Sánchez E, Vargas M, et al. Anemia and thrombocytopenia in children with Plasmodium vivax malaria. J Trop Pediatr 2006; 52:49.

Nosten F, McGready R, Simpson JA, et al. Effects of Plasmodium vivax malaria in pregnancy. Lancet 1999; 354:546.

Kochar DK, Tanwar GS, Khatri PC, et al. Clinical features of children hospitalized with malaria--a study from Bikaner, northwest India. Am J Trop Med Hyg 2010; 83:981.

Roberts DJ, Casals-Pascual C, Weatherall DJ. The clinical and pathophysiological features of malarial anaemia.Curr Top MicrobiolImmunol 2005; 295:137.

Abdalla, S, H., Pasvol, G. Malaria: A Hematological Perspective, Imperial College Press, London 2004.

Newton CR, Warn PA, Winstanley PA, et al. Severe anaemia in children living in a malaria endemic area of Kenya. Trop Med Int Health 1997; 2:165.

Das BS, J Vector Borne Dis 2008.

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Published

2012-09-30

How to Cite

1.
Rathod CC, Deshpande SV, Rana HM, Godbole VY, Patel A, Patel V, Darad D, Panchal M. Plasmodium Falciparum Versus Plasmodium Vivax: Which Is a Lesser Evil?. Natl J Community Med [Internet]. 2012 Sep. 30 [cited 2024 Dec. 13];3(03):541-7. Available from: https://njcmindia.com/index.php/file/article/view/1761

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Original Research Articles