Abstract

Background: Malaria is the major cause of infectious disease death in India. Plasmodium vivax (PV) is the most common cause of malaria among humans affecting about 25 billion population worldwide. India is having 80% of malaria cases among South East Asia region. India being the country having different geographical regions and climate, the pattern of malaria vary with places. Objectives: This study was done to study the clinical features, diagnosis, laboratory investigations, outcome, and complications of malaria in a tertiary care hospital of Bareilly.
Materials and Methods: A prospective analysis of adult patients suffering from malaria was carried out during the year 2014-2015. Diagnosis of the patients was done on clinical features, peripheral smear examination, and rapid diagnostic test. The parasitic count was done from peripheral blood smear. The clinical features, laboratory investigations, treatment, and outcome were studied. The response to treatment was determined on the basis of improvement of clinical features and repeated peripheral blood smear examinations.
Results: Out of the 126 patients, 71 (56.34%) were males and 55 (43.65%) were females in the age group of 15-70 years. Fever was universal presentation (P < 0.001). 47.6% of the patients complained of headache, 29.36% had vomiting. Jaundice was observed in 20.63% patients. Anemia was present 53.17%. All above results were statistically significant. 15.87% presented with loss of sleep, 7.93% as acute abdomen, 4.76% as convulsion, and 3.96% as bleeding as a result of thrombocytopenia (statistically non-significant). Among 126 malaria cases, 62 (49.2%) were with PV, 36 (28.57%) with Plasmodium falciparum, and 18 (14.28%) had mixed infection. 10 were smear negative patients, and they received empirical treatment on the basis of sign and symptoms of malaria. Conclusion: Majority of hospitalized patients were vivax positive. Complicated malaria was seen with Falciparum infection. Clinical symptomatology without blood smear positivity can be the basis of starting treatment. Epidemiological survey for drug resistance should be considered while planning an antimalarial strategy.