DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192056

Clinical profile and renal complications among cases of malaria in children attending a tertiary care hospital of South India

Tenali Ravi Kumar, Sai Lakshmi Ananya Tenali

Abstract


Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.

Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ≤0.05.

Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.

Conclusions:  Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.


Keywords


Acute renal failure, Cerebral malaria, Hyperparasitoid, Malaria

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References


World malaria report. Geneva: World Health Organization. 2017. Available at: http://www.who.int/malaria/publications/world-malaria-report-2017/en/. Accessed 14 October 2018.

Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526(7572):207.

Nand N, Aggarwal H, Sharma M, Singh M. Systemic manifestations of malaria. J Indian Acad Clin Med. 2001;2(3):189-4.

High burden to high impact: getting back on track to end malaria. Geneva: World Health Organization. 2018. Available at: www.who.int/malaria/publications/atoz/high-impact-response/en/. Accessed 7 November 2018.

Yadav D, Chandra J, Aneja S, Kumar V, Kumar P, Dutta AK. Changing profile of severe malaria in north Indian children. Indian J Pediatr. 2012;79(4):483-7.

Patel U, Gandhi G, Friedman S, Niranjan S. Thrombocytopenia in malaria. J National Med Assoc. 2004;96(9):1212.

Jasani JH, Sancheti SM, Gheewala BS, Bhuva KV, Doctor VS, Vacchani AB, et al. Association of the electrolyte disturbances (Na+, K+) with the type and severity of the malarial parasitic infection. J Clin Diagn Res. 2012;6(4):678-1.

Marsh K, Forster D, Waruiru C, Mwangi I, Winstanley M, Marsh V, et al. Indicators of life-threatening malaria in African children. New Eng J Med. 1995;332(21):1399-404.

Shetty G, Avabratha KS, Gonsalves S, Dany A, Rai BS. Thrombocytopenia in children with malaria-A study from coastal Karnataka, India. Asia Pacific J Trop Dis. 2012;2(2):107-9.

Faseela TS, Ronald AR, Anitha KB, Chaithra SM, Yashwanth R. Diagnostic value of platelet count in malaria. J Clin Diagn Res. 2011;5(3): 464.

Muddaiah M, Prakash PS. A study of clinical profile of malaria in a tertiary referral centre in South Canara. J Vector Borne Dis. 2006;43(1):29.

Sowunmi A. Renal function in acute falciparum malaria. Arch Dis Childhood. 1996;74(4):293-8.

Rasheed A, Saeed S, Khan SA. Clinical and laboratory findings in acute malaria caused by various plasmodium species. J Pak Med Assoc. 2009;59(4):220-3.

Harris VK, Richard VS, Mathai E, Sitaram U, Kumar KV, Cherian AM, et al. A study on clinical profile of falciparum malaria in a tertiary care hospital in south India. Ind J Malariol. 2001;38 (1-2):19-24.

Taha K, El-Dein SZ, Idrees M, Makboul G, Baidas G. Haematological changes in malaria: relation to Plasmodium species. Kuwait Med J. 2007;39 (3):262.

Singh RK. Emergence of chloroquine-resistant vivax malaria in south Bihar (India). Trans R Soc Trop Med Hyg. 2000;94:327.

Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: Severe malaria. Crit Care. 2003;7(4):315.

Sanklecha MU, Raghavan K, Mehta MN. Cerebral malaria vivax or mixed. Indian Pediatr. 1994;31(9):1133-4.

Price RN, Douglas NM, Anstey NM. New developments in Plasmodium vivax malaria: severe disease and the rise of chloroquine resistance. Current Opin Inf Dis. 2009;22(5):430-5.

Manan JA, Ali H, Lal M. Acute renal failure associated with malaria. J Ayub Med Coll Abbottabad. 2006;18(4):47-52.

Prakash J, Singh AK, Gujrati S, Maheshwari A. Acute renal failure in Malaria: changing trends. Indian J Nephrol. 2002;12:113-7.