title: Demographic and clinical profiles of Plasmodium falciparum and Plasmodium vivax patients at a tertiary care centre in southwestern India.
abstract: Malaria remains an important cause of morbidity and mortality in India. Though many comprehensive studies have been carried out in Africa and Southeast Asia to characterize and examine determinants of Plasmodium falciparum and Plasmodium vivax malaria pathogenesis, fewer have been conducted in India.
  
  
  
  A prospective study of malaria-positive individuals was conducted at Goa Medical College and Hospital (GMC) from 2012 to 2015 to identify demographic, diagnostic and clinical indicators associated with P. falciparum and P. vivax infection on univariate analysis.
  
  
  
  Between 2012 and 2015, 74,571 febrile individuals, 6287 (8.4%) of whom were malaria positive, presented to GMC. The total number of malaria cases at GMC increased more than two-fold over four years, with both P. vivax and P. falciparum cases present year-round. Some 1116 malaria-positive individuals (mean age = 27, 91% male), 88.2% of whom were born outside of Goa and 51% of whom were construction workers, were enroled in the study. Of 1088 confirmed malaria-positive patients, 77.0% had P. vivax, 21.0% had P. falciparum and 2.0% had mixed malaria. Patients over 40 years of age and with P. falciparum infection were significantly (p < 0.001) more likely to be hospitalised than younger and P. vivax patients, respectively. While approximately equal percentages of hospitalised P. falciparum (76.6%) and P. vivax (78.9%) cases presented with at least one WHO severity indicator, a greater percentage of P. falciparum inpatients presented with at least two (43.9%, p < 0.05) and at least three (29.9%, p < 0.01) severity features. There were six deaths among the 182 hospitalised malaria positive patients, all of whom had P. falciparum.
  
  
  
  During the four year study period at GMC, the number of malaria cases increased substantially and the greatest burden of severe disease was contributed by P. falciparum.
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Chery
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Maki
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Mascarenhas
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Jayashri T
authors.initials: JT
authors.lastname: Walke
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Gawas
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Anvily
authors.initials: A
authors.lastname: Almeida
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Mezia
authors.initials: M
authors.lastname: Fernandes
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Marina
authors.initials: M
authors.lastname: Vaz
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Ramanan
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Diksha
authors.initials: D
authors.lastname: Shirodkar
authors.affiliation: Center for Infectious Disease Research (CIDR), Seattle, WA, 98109, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Bernabeu
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Suresh Kumar
authors.initials: SK
authors.lastname: Manoharan
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Ligia
authors.initials: L
authors.lastname: Pereira
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Dash
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Ambika
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Riaz Basha
authors.initials: RB
authors.lastname: Shaik
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Rimi
authors.initials: R
authors.lastname: Chakrabarti
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.|Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Prasad
authors.initials: P
authors.lastname: Babar
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.
authors.forename: John
authors.initials: J
authors.lastname: White
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.
authors.forename: Devaraja G
authors.initials: DG
authors.lastname: Mudeppa
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.
authors.forename: Shiva
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authors.lastname: Kumar
authors.affiliation: Department of Biology, Stanford University, Stanford, CA, 94305, USA.
authors.forename: Wenyun
authors.initials: W
authors.lastname: Zuo
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Skillman
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.
authors.forename: Usheer
authors.initials: U
authors.lastname: Kanjee
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.
authors.forename: Caeul
authors.initials: C
authors.lastname: Lim
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Shaw-Saliba
authors.affiliation: National Institute of Malaria Research, Field Unit, Campal, Goa, 403001, India.
authors.forename: Ashwani
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authors.affiliation: National Institute of Malaria Research (ICMR), Sector 8, Dwarka, New Delhi, 110077, India.
authors.forename: Neena
authors.initials: N
authors.lastname: Valecha
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: V N
authors.initials: VN
authors.lastname: Jindal
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Anar
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authors.lastname: Khandeparkar
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Pradeep
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authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Sunanda
authors.initials: S
authors.lastname: Amonkar
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA.
authors.forename: Manoj T
authors.initials: MT
authors.lastname: Duraisingh
authors.affiliation: Department of Biology, Stanford University, Stanford, CA, 94305, USA.
authors.forename: Shripad
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authors.lastname: Tuljapurkar
authors.affiliation: Center for Infectious Disease Research (CIDR), Seattle, WA, 98109, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Smith
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Nagesh
authors.initials: N
authors.lastname: Dubhashi
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Roque G W
authors.initials: RG
authors.lastname: Pinto
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Maria
authors.initials: M
authors.lastname: Silveria
authors.affiliation: Goa Medical College and Hospital, Bambolim, Goa, 403202, India.
authors.forename: Edwin
authors.initials: E
authors.lastname: Gomes
authors.affiliation: Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA. rathod@chem.washington.edu.
authors.forename: Pradipsinh K
authors.identifier: 0000-0001-7394-1360
authors.initials: PK
authors.lastname: Rathod
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D016780:Malaria, Vivax / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Characteristics; Diagnostics; Epidemiology; Features; Goa; MESA-ICEMR; Severity