title: Morbidity and mortality associated with Plasmodium vivax and Plasmodium falciparum infection in a tertiary care kidney hospital.
abstract: Malaria is a disease of tropical regions and both types of plasmodia, i.e. Plasmodium falciparum and Plasmodium vivax, cause significant morbidity and mortality. P. vivax was thought to be benign and cause less morbidity and mortality. Many reports showed the devastating effect of vivax malaria too. We compared the clinical symptoms, laboratory markers, treatment and outcome of both the plasmodia. This is a retrospective analysis of 95 patients admitted to The Kidney Center, Karachi in a duration of 15 years (1997-2012); 45 patients with falciparum malaria and 50 patients with vivax malaria, and compared the clinical presentation, laboratory workup, treatment and outcome in both groups. The two groups constitute a mixed population of diabetes, chronic kidney disease (CKD) and hemodialysis patients. Both plasmodia have an equal clinical impact in terms of fever and rigors, anorexia, nausea, feeling of dyspnea, change in the mental status, changes in the urine color, diarrhea, volume depletion and pedal edema. However, patients with falciparum had significantly more vomiting (P = 0.02), oliguria (P = 0.003) and jaundice (P = 0.003). Laboratory parameters also showed a severe impact of falciparum, as there was more severe anemia and kidney and liver dysfunction. More patients were treated with dialysis and blood transfusion in the falciparum group. The outcome in the two groups was not significantly different in terms of death and days of hospitalization. Falciparum malaria has a higher clinical impact than the vivax malaria, but vivax is not as benign as it was once thought to be. It also has devastating effects on vulnerable populations like patients with CKD and diabetes.
authors.affiliation: Department of Nephrology, Dorab Patel Post Graduate Training and Research Center, The Kidney Center Post Graduate Training Institute, Karachi, Pakistan.
authors.forename: Salman
authors.initials: S
authors.lastname: Imtiaz
authors.forename: Murtaza F
authors.initials: MF
authors.lastname: Drohlia
authors.forename: Kiran
authors.initials: K
authors.lastname: Nasir
authors.forename: Mehwish
authors.initials: M
authors.lastname: Hussain
authors.forename: Aasim
authors.initials: A
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D016778:Malaria, Falciparum / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016780:Malaria, Vivax / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult