title: Incidence of Jaundice in Plasmodium vivax Malaria: A Prospective Study in Moodabidri, South India.
abstract: BACKGROUND
  A prospective study was taken to look for the incidence of jaundice in Plasmodium vivax malaria patients in Moodabidri, a coastal town of South India.
  
  
  METHODS
  A prospective study was conducted in the patients admitted with the diagnosis of Plasmodium vivax malaria at the Alva's health centre, during study period 1st Jun 2011 to 10th October 2012. Bilirubin levels were checked in all the selected patients. Patients who had their total bilirubin level 3.0 mg% or more were considered to be having jaundice and were further tested for anemia and hepatic dysfunction by carrying out hemoglobin (Hb), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), surface antigen of the hepatitis B virus (HBsAg). The data collected were analysed statistically.
  
  
  RESULTS
  A total of 188 patients who had Plasmodium vivax malaria as diagnosed by peripheral blood film (PBF) and rapid diagnostic test (RDT) were included in the study. Jaundice was present in 19 (10.1%) patients and the mean (SD) level of serum bilirubin was 4.5 mg/dL (2.4) (maximum = 12.7 mg %) with 94.7% (n = 18) of the patients having predominantly indirect type or unconjugated hyperbilirubinemia. The hepatic dysfunction was present in 15 (78.9%) with mean (SD) level of aspartate aminotransferase (AST) was 61.57 IU/L (SD 33.8) (maximum = 160 IU/L) and alanine aminotransferase (ALT) was 54.8 IU/L (SD 21.2) (maximum = 108 IU/L). Anemia was present in 3 (15.8%) patients and the mean hemoglobin level was 12.8 gm/dL (SD 1.8) (minimum = 6.4 gm/dL). Out of 19 patients who had jaundice majority were males (94.7 %, n = 18) and only one female (5.3%, n = 1) was found to be having jaundice. The age of the patients who had jaundice ranged from 17 to 60 years 29 years (SD 13.7).
  
  
  CONCLUSIONS
  This study has further reiterated the fact that Plasmodium vivax malaria is no longer a "benign" disease and it can also produce jaundice, hepatic dysfunction, and anemia.
authors.affiliation: Department of Internal Medicine, Alva's Health Centre, Moodabidri - 574227, Karnataka, India.
authors.forename: Bolar Sadananda
authors.initials: BS
authors.lastname: Naik
keywords: Plasmodium vivax malaria; anemia; hepatitis; jaundice