title: Complicated malaria symptoms associated with Plasmodium vivax among patients visiting health facilities in Mendi town, Northwest Ethiopia.
abstract: Malaria is still a major health problem in some parts of the world. Plasmodium falciparum is the common pathogenic parasite and is responsible for majority of malaria associated deaths. Recently the other benign parasite, P. vivax, is reported to cause life threatening severe malaria complications. Thus, this study was aimed to assess incidence of severe malaria symptoms caused by P. vivax parasite in some malaria endemic areas of Ethiopia.
  
  
  
  Presumptive malaria patients (all age groups) seeking medication at the selected health facilities in Mendi town, Northwest Ethiopia, were recruited for the study. Socio-demographic, clinical and parasitological characteristics were assessed following standard procedures. Data was analyzed using descriptive statistics, chi-square test and relative risk.
  
  
  
  Of the 384 patients enrolled in the study for P. vivax mono-infection, 55 (14.3 %) of them were fulfilled at least one of the WHO criteria for severe malaria indicators. Some of these clinical manifestations were: prostration 14 (25.45 %), persistent vomiting 9 (16.36 %), respiratory distress 6 (10.9 %), hypoglycemia 5 (9.1 %), hyperpyrexia 8 (14.5 %), and severe anemia 13 (23.63 %). Differences in parasite load did not affect the frequency of some severe malaria symptoms. However, severe anemia, prostration, and persistent vomiting were significantly affected (P < 0.05) by relatively higher load of parasitemia, (OR = 3.8, 95 % CI, 1.1-13.7; OR = 4.4, 95 % CI, 1.4-13.9; and OR = 7, 95 % CI, 1.8-27.4) respectively.
  
  
  
  P.vivax associated severe malaria symptoms observed in this study is supportive evidence for the notion that P.vivax is no longer benign parasite but rather virulent. Thus, to meet international and regional targets of malaria eradication, a holistic prevention and control approaches should be designed.
authors.affiliation: Department of Biology, College of Natural Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Yohannes
authors.initials: Y
authors.lastname: Demissie
authors.affiliation: Department of Biology, College of Natural Sciences, Jimma University, Jimma, Ethiopia. tsigeketema@gmail.com.
authors.forename: Tsige
authors.initials: T
authors.lastname: Ketema
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006268:Health Facilities; D006359:Heat Exhaustion / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology; D016780:Malaria, Vivax / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D059208:Parasite Load; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification*; D014839:Vomiting / Q000209:etiology; D055815:Young Adult
keywords: Hemoglobin; Hypoglycemia; P. vivax; Respiratory distress; Severe malaria