title: Comparison of the Clinical Profile and Complications of Mixed Malarial Infections of Plasmodium Falciparum and Plasmodium Vivax versus Plasmodium Falciparum Mono-infection.
abstract: OBJECTIVE
  This study aimed to compare the clinical presentations and complications in patients having mixed malaria infection of Plasmodium falciparum and Plasmodium vivax with those of patients with malaria due to a P. falciparum mono-infection.
  
  
  METHODS
  The medical records of malaria patients admitted to Kasturba Medical College, Manipal, India, during the years 2008-10 were analysed. Inclusion criteria were patients in whom P. falciparum and P. vivax coinfection or P. falciparum mono-infection alone was confirmed on peripheral smear examination. Exclusion criteria were patients in whom P. vivax infection alone was diagnosed on peripheral smear examination. The sample size was twenty patients diagnosed with mixed infection of P. falciparum and P. vivax and 60 patients diagnosed with P. falciparum mono-infection.
  
  
  RESULTS
  35% of mixed infections had thrombocytopenia as compared to 51.7% of P. falciparum mono-infections. A total of 5% of the mixed infections had renal failure as compared to 16.7% of the falciparum mono-infections. Total bilirubin was raised in 15.8% of mixed infections and in 46.6% of falciparum mono-infections. Abnormal liver enzymes were seen in 36.8% of mixed infections and in 66.6% of falciparum mono-infections. None of the mixed infections had a parasite index over 2% while it was present in 28% of the falciparum mono-infections.
  
  
  CONCLUSIONS
  Patients with mixed infections were found to have a lower incidence of severe complications such as anaemia, thrombocytopenia, liver and renal dysfunction and a lower parasite index. Thus mixed malaria tends to have a more benign course as compared to malaria due to P. falciparum mono-infection.
authors.affiliation: Medical Students and.
authors.forename: Vivek
authors.initials: V
authors.lastname: Joseph
authors.forename: Muralidhar
authors.initials: M
authors.lastname: Varma
authors.forename: Sudha
authors.initials: S
authors.lastname: Vidhyasagar
authors.forename: Alvin
authors.initials: A
authors.lastname: Mathew
references.citation: Am J Kidney Dis. 1998 Sep;32(3):361-75
references.pmid: 9740151
references.citation: C R Acad Sci III. 1998 Aug;321(8):689-97
references.pmid: 9769862
references.citation: J Trop Med Hyg. 1986 Apr;89(2):51-5
references.pmid: 3534280
references.citation: Parasitology. 2001 Feb;122(Pt 2):233-51
references.pmid: 11272654
references.citation: Trans R Soc Trop Med Hyg. 1999 Jul-Aug;93(4):433-8
references.pmid: 10674098
references.citation: Trans R Soc Trop Med Hyg. 1988;82(5):667-70
references.pmid: 3075351
references.citation: Parasitology. 1999 Oct;119 ( Pt 4):337-42
references.pmid: 10581610
references.citation: Am J Trop Med Hyg. 2001 Nov;65(5):614-22
references.pmid: 11716124
references.citation: Lancet. 1999 Aug 14;354(9178):546-9
references.pmid: 10470698
references.citation: J Am Soc Nephrol. 2000 Nov;11(11):2147-2154
references.pmid: 11053494
references.citation: Blut. 1981 Mar;42(3):157-64
references.pmid: 7011445
references.citation: Trends Parasitol. 2004 May;20(5):233-40
references.pmid: 15105024
references.citation: Trends Parasitol. 2001 Dec;17(12):593-7
references.pmid: 11756044
references.citation: Clin Infect Dis. 2001 Sep 1;33(5):676-85
references.pmid: 11486290
references.citation: Thromb Haemost. 1981 Aug 28;46(2):547-9
references.pmid: 6458113
references.citation: Clin Infect Dis. 2008 Jan 15;46(2):165-71
references.pmid: 18171245