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Acute Malaria: 8 Years (2008-2015) Experience of Distribution, Clinical Manifestations, Severity and Outcomes from North India

Sohaib Ahmad, Nadia Shirazi, Minakshi Dhar, Nowneet K Bhat, Saurabh Srivastava, Mohamad Akram and Garima Mittal

This north Indian retrospective hospital-based observational study analysed the distribution, clinical features, the outcomes and
the burden of complications of acute malaria associated with mono and co-infections by P. vivax and P. falciparum of the 1663 patients
presenting between 2008-2015, 59.4% and 36.9% had P. vivax and P. falciparum mono-infections while 3.6% were co-infected. P.
falciparum cases peaked between 2010-2012, there after; P. vivax has emerged as the dominant species. Severe thrombocytopenia
(29.8%), shock (22.7%), renal dysfunction (19.8%), liver dysfunction (17.5%), hypoglycaemia (10.5%), cerebral malaria (8.3%), severe
anaemia (5%) and respiratory distress (4.5%) were the main complications and 1% patients succumbed to malaria. While P. vivax monoinfection
was significantly associated with renal dysfunction and severe thrombocytopenia, co-infection with P. falciparum was significantly
associated with hypoglycaemia, neurological dysfunction, acute respiratory distress and unfavourable outcome. Renal dysfunction was
significantly associated with concomitant liver and respiratory dysfunction (p<0.05) and mortality.