What was thought to be milder malaria may not be so: Study


Ganga Ram docs link 'benign' parasite with platelet drop, liver problems.

A malaria parasite responsible for the milder form of the disease — Plasmodium vivax — has been linked with severe complications in patients. A new study by Sir Ganga Ram Hospital doctors on 165 patients, published in the journal Tropical Doctor, says the parasite may be deadlier than thought.

Of 121 patients diagnosed with vivax malaria, three died of Acute Respiratory Distress Syndrome (ARDS). Other complications seen in the study group include thrombocytopenia (drop in platelets), liver problems, and kidney damage.

Malaria is a vector-borne disease and the parasite is carried by the female Anopheles mosquito. The two variants of the disease are attributed to parasites within the Plasmodium family: vivax and falciparum. The latter leads to the more aggressive form of malaria.

The study says: "P. vivax malaria, although considered to be a benign entity, can have a severe and complicated course, which is usually associated with P. falciparum malaria."

Dr Atul Gogia, corresponding author of the study, said, "In the northern belt, vivax malaria is more common than P. falciparum. The only cases of the latter are seen in travellers."

He says the severity in complications could be due to a number of reasons. "It could be increased drug resistance or mutation or simply a matter of better understanding of the disease. It is difficult to identify a single cause, but it is clear that these patients need closer observation and should be admitted wherever there are indications of complications," Dr Gogia says.

In the study, fall in platelets was seen in 113 patients (68 per cent), with counts dropping below 20 x 103/uL (generally regarded as the level below which blood transfusion is needed) in 43 patients (7 per cent).

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