Clinical Features and Outcomes in Patients Presenting with Plasmodium Falciparum
DOI:
https://doi.org/10.70749/ijbr.v3i5.1414Keywords:
Plasmodium, Falciparum, Malaria, Severe Disease, Multi-organ DysfunctionAbstract
Background: Despite international efforts to lessen its effects, Plasmodium falciparum malaria continues to pose a serious threat to public health in endemic areas. There is little information available on the clinical characteristics and results of P. falciparum infections, in contrast to P. vivax, which is more commonly in South Asia. The purpose of this study was to assess the range of P. falciparum-related clinical symptoms and sequelae among hospitalized patients in a Pakistani tertiary care facility. Objective: To determine the common clinical features, complications, and outcomes in adult patients presenting with Plasmodium falciparum malaria. Methods: Over the course of six months, Bolan Medical College/Hospital conducted this qualitative, descriptive cross-sectional study. Using sequential sampling, 167 patients with proven P. falciparum infections between the ages of 18 and 65 were included. Physical tests and structured interviews were used to document clinical characteristics and problems. Co-morbid conditions such as cancer, autoimmune diseases, chronic liver disease, or recent blood transfusions were not included in the study. Results: Fever was universal (100%), followed by chills and rigors (92.2%), headache (71.9%), vomiting (64.7%), and myalgia (58.7%).Common physical signs included pallor (68.9%), hepatomegaly (47.3%), splenomegaly (37.7%), jaundice (36.5%), and altered consciousness (17.3%) Major complications observed were malarial hepatitis (37.7%), acute kidney injury (24.5%), severe anemia (19.2%), cerebral malaria (8.4%), ARDS (5.3%), and multi-organ dysfunction (4.4%). Conclusion: Plasmodium falciparum malaria in this study presented with a broad clinical spectrum and substantial risk for serious complications. Malarial hepatitis and AKI were the most common complications, while cerebral malaria and ARDS, though less frequent, signaled severe disease. Early recognition of atypical presentations and prompt, comprehensive management are essential to reducing morbidity and mortality in endemic regions.
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References
White, N. J., Pukrittayakamee, S., Hien, T. T., Faiz, M. A., Mokuolu, O. A., & Dondorp, A. M. (2014). Malaria. The Lancet, 383(9918), 723-735.
https://doi.org/10.1016/s0140-6736(13)60024-0
WHO. Malaria 2013 [12 March 2023].
http://who.int/malaria/publications/worldmalariareport2013/en
Grobusch, M. P., & Kremsner, P. G. (2005). Uncomplicated malaria. Malaria: Drugs, disease and post-genomic biology, 81-104.
https://doi.org/10.1007/3-540-29088-5_4
Maitland, K., & Marsh, K. (2004). Pathophysiology of severe malaria in children. Acta Tropica, 90(2), 131-140.
https://doi.org/10.1016/j.actatropica.2003.11.010
Shekalaghe, S., Alifrangis, M., Mwanziva, C., Enevold, A., Mwakalinga, S., Mkali, H., Kavishe, R., Manjurano, A., Sauerwein, R., Drakeley, C., & Bousema, T. (2009). Low density parasitaemia, red blood cell polymorphisms and plasmodium falciparumspecific immune responses in a low endemic area in northern Tanzania. BMC Infectious Diseases, 9(1).
https://doi.org/10.1186/1471-2334-9-69
Feachem, R. G., Phillips, A. A., Hwang, J., Cotter, C., Wielgosz, B., Greenwood, B. M., Sabot, O., Rodriguez, M. H., Abeyasinghe, R. R., Ghebreyesus, T. A., & Snow, R. W. (2010). Shrinking the malaria map: Progress and prospects. The Lancet, 376(9752), 1566-1578.
https://doi.org/10.1016/s0140-6736(10)61270-6
Arévalo-Herrera, M., Lopez-Perez, M., Medina, L., Moreno, A., Gutierrez, J. B., & Herrera, S. (2015). Clinical profile of plasmodium falciparum and plasmodium vivax infections in low and unstable malaria transmission settings of Colombia. Malaria Journal, 14(1).
https://doi.org/10.1186/s12936-015-0678-3
Wasnik, P. N., Manohar, T. P., Humaney, N. R., & Salkar, H. R. (2012). Study of clinical profile of falciparum malaria in a tertiary referral centre in Central India. The Journal of the Association of Physicians of India, 60, 33-36.
https://europepmc.org/article/med/23777023
Chandrashekar, U. K., & Sudharshan Murthy, K. A. (2011). Sunila. A study on clinical profile and outcome in falciparum malaria. Calicut Medical Journal, 9(3), e6.
WHO. World Malaria Report 2023. Geneva: World Health Organization; 2023.
White, N. J., Turner, G. D., Day, N. P., & Dondorp, A. M. (2013). Lethal malaria: Marchiafava and Bignami were right. Journal of Infectious Diseases, 208(2), 192-198.
https://doi.org/10.1093/infdis/jit116
Mohapatra, M. K, & Das, S. P. (2009). The spectrum of complications of severe falciparum malaria. J Assoc Physicians India, 57, 754–760.
Chandrashekar N, et al. (2018). Clinical profile and complications of Plasmodium falciparum malaria. Indian J Med Res, 148(1), 34–38.
Kochar, D. K., Agarwal, P., Kochar, S. K., Jain, R., Rawat, N., Pokharna, R. K., ... & Srivastava, T. (2003). Hepatocyte dysfunction and hepatic encephalopathy in Plasmodium falciparum malaria. Qjm, 96(7), 505-512.
https://doi.org/10.1093/qjmed/hcg091
Mishra, S. K, Mohanty, S, & Das B. S. (2002). Prognostic indicators of falciparum malaria in adults. J Assoc Physicians India, 50, 412–416.
Prakash, J., Singh, A. K., Gujrati, S., & Maheshwari, A. (2002). Acute renal failure in malaria: changing trends. Indian Journal of Nephrology, 12(4), 113-117.
BARSOUM, R. S. (2000). Malarial acute renal failure. Journal of the American Society of Nephrology, 11(11), 2147-2154.
https://doi.org/10.1681/asn.v11112147
Idro, R., Jenkins, N. E., & Newton, C. R. (2005). Pathogenesis, clinical features, and neurological outcome of cerebral malaria. The Lancet Neurology, 4(12), 827-840.
https://doi.org/10.1016/s1474-4422(05)70247-7
Taylor, W. R., Hanson, J., Turner, G. D., White, N. J., & Dondorp, A. M. (2012). Respiratory manifestations of malaria. Chest, 142(2), 492-505.
https://doi.org/10.1378/chest.11-2655
Dondorp AM, et al. Predictors of mortality in severe falciparum malaria: a meta-analysis of individual patient data. Lancet Infect Dis. 2010;10(6):455–463.
Singh, R., Mehta, A., & Verma, S. (2020). Clinical spectrum and outcome of Plasmodium falciparum malaria in a tertiary care hospital in eastern India. Tropical Parasitology, 10(1), 12–17.
Baluku, J. B., Sserunjogi, R., & Bongomin, F. (2022). Clinical characteristics and outcomes of adult patients with Plasmodium falciparum malaria in a tertiary Ugandan hospital. Malaria Journal, 21(1), 1–9.
Ahmed, S. H., Khan, M. T., & Jafri, F. (2021). Spectrum of complications in severe falciparum malaria: A retrospective study from a tertiary hospital in southern Pakistan. Pakistan Journal of Medical Sciences, 37(5), 1450–1455.
Rahman, M., Nasreen, T., & Hossain, M. (2023). Atypical presentations of Plasmodium falciparum malaria in an urban hospital setting. Journal of Infection in Developing Countries, 17(1), 29–36.
Ogunyemi, A. S., Lawal, T. A., & Adewale, A. A. (2022). Predictors of poor outcome in falciparum malaria: A Nigerian tertiary hospital experience. Annals of African Medicine, 21(3), 120–126.
Mårtensson, A., Ochola, L., & Yeung, S. (2021). Severe falciparum malaria: Determinants of clinical outcome in multi-country observational study. The Lancet Global Health, 9(8), e1102–e1110.
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