Thrombocytopenia in vivax and falciparum malaria: an observational study of 131 patients in Karnataka, India

Objectives. Chikungunya and scrub typhus infection are important causes of undifferentiated fever in tropical zones. The clinical manifestations in both conditions are nonspecific and often overlap. This study compares the clinical manifestations and the outcome of chikungunya with chikungunya-scrub typhus coinfection in children. Methods. A hospital-based observational study was conducted in children below 15 years of age over 16-month duration in 2017-2018. Chikungunya was diagnosed by IgM ELISA. All positive chikungunya cases were subjected to scrub typhus testing, dengue testing, leptospira testing, and malaria testing. Clinical manifestations and outcomes of all patients were recorded. Results. Out of the 382 admitted cases with fever, 11% ( n = 42 ) were diagnosed with chikungunya, and the majority ( n = 30 , 71.4%) were male. Among the 42 chikungunya cases, 17 (40.5%) tested positive for scrub typhus and one positive for falciparum malaria. Out of a total of 42 chikungunya cases, myalgia, nausea/vomiting, headache, abdominal pain, lymphadenopathy, hepatomegaly, splenomegaly, and edema were 81%, 73.8%, 66.7%, 64.3%, 59.5%, 52.4%, 40.5%, and 38.1%, respectively. Besides, altered sensorium (31%), jaundice (26.2%), dry cough (21.4%), shortness of breath (19%), and seizures (16.7%) were other clinical manifestations present in this group of children. Patients with chikungunya-scrub typhus coinfection reported headaches, pain in the abdomen, dry cough, shortness of breath, seizures, and splenomegaly, significantly more ( p value < 0.05) compared to those with chikungunya only. Thirteen (31%) children developed shock, five in the chikungunya group and eight in the chikungunya-scrub typhus coinfection group. Six children in the coinfection group received inotrope. Among the chikungunya-only cases, 22 recovered and one died, whereas in the chikungunya-scrub typhus coinfection group, fourteen recovered and three died. Conclusions. Both the chikungunya and scrub typhus coinfection groups shared many similar clinical manifestations. In children, coinfection with scrub typhus often leads to modification of the clinical profile, complications, and chikungunya outcome.

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Effect of generalised access to early diagnosis and treatment and targeted mass drug administration on Plasmodium falciparum malaria in Eastern Myanmar: an observational study of a regional elimination programme

The Lancet ◽

10.1016/s0140-6736(18)30792-x ◽

2018 ◽

Vol 391 (10133) ◽

pp. 1916-1926 ◽

Cited By ~ 67

Author(s):

Jordi Landier ◽

Daniel M Parker ◽

Aung Myint Thu ◽

Khin Maung Lwin ◽

Gilles Delmas ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Early Diagnosis ◽

Observational Study ◽

Falciparum Malaria ◽

Drug Administration ◽

Mass Drug Administration ◽

Plasmodium Falciparum Malaria ◽

Diagnosis And Treatment ◽

Elimination Programme

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FALCIPARUM MALARIA – IT’S VARIED PRESENTATION : AN OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1632 ◽

2015 ◽

Vol 4 (65) ◽

pp. 11316-11321

Author(s):

Prabhu S ◽

Raveendra K R

Keyword(s):

Observational Study ◽

Falciparum Malaria ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital

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Geographical concentration of falciparum malaria treated in the UK and delay to treatment with artesunate in severe cases: an observational study

BMJ Open ◽

10.1136/bmjopen-2012-001854 ◽

2012 ◽

Vol 2 (6) ◽

pp. e001854 ◽

Cited By ~ 4

Author(s):

Claire Broderick ◽

Philip Friend ◽

Valerie Smith ◽

Marie Blaze ◽

Philip Gothard ◽

...

Keyword(s):

Observational Study ◽

Falciparum Malaria ◽

Geographical Concentration ◽

The Uk

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Associations Between Restrictive Fluid Management and Renal Function and Tissue Perfusion in Adults With Severe Falciparum Malaria: A Prospective Observational Study

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz449 ◽

2019 ◽

Vol 221 (2) ◽

pp. 285-292

Author(s):

Haruhiko Ishioka ◽

Katherine Plewes ◽

Rajyabardhan Pattnaik ◽

Hugh W F Kingston ◽

Stije J Leopold ◽

...

Keyword(s):

Renal Function ◽

Observational Study ◽

Falciparum Malaria ◽

Prospective Observational Study ◽

Fluid Intake ◽

Fluid Management ◽

Tissue Perfusion ◽

Total Fluid Intake ◽

Severe Falciparum Malaria ◽

Total Fluid

Abstract Background Liberal fluid resuscitation has proved harmful in adults with severe malaria, but the level of restriction has not been defined. Methods In a prospective observational study in adults with severe falciparum malaria, restrictive fluid management was provided at the discretion of the treating physician. The relationships between the volume of fluid and changes in renal function or tissue perfusion were evaluated. Results A total of 154 patients were studied, 41 (26.6%) of whom died. Median total fluid intake during the first 6 and 24 hours from enrollment was 3.3 (interquartile range [IQR], 1.8–5.1) mL/kg per hour and 2.2 (IQR, 1.6–3.2) mL/kg per hour, respectively. Total fluid intake at 6 hours was not correlated with changes in plasma creatinine at 24 hours (n = 116; rs = 0.16; P = .089) or lactate at 6 hours (n = 94; rs = −0.05; P = .660). Development of hypotensive shock or pulmonary edema within 24 hours after enrollment were not related to the volume of fluid administration. Conclusions Restrictive fluid management did not worsen kidney function and tissue perfusion in adult patients with severe falciparum malaria. We suggest crystalloid administration of 2–3 mL/kg per hour during the first 24 hours without bolus therapy, unless the patient is hypotensive.

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