ISSN - 0973-0958

DOI : 10.7199/ped.oncall.2012.80
Changing Trends in Clinical Presentation of Pediatric Malaria
Sushant S Mane, Mrinal Matish, Ashok D Rathod, Vipin V Goyal
Department of Pediatrics, Grant Medical College, Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India

Aim: This retrospective study was undertaken to determine incidence of different clinical presentations in pediatric malaria and its correlation with parasitology of disease.

Methods: Case records of 100 children admitted in pediatric ward of a tertiary care hospital from June 2010 to September 2011were studied. All children below 12 years of age with any of the following diagnosis based on peripheral smear examination were included: a) P. vivax malaria, b) P. falciparum malaria, c) Mixed infection (both vivax and falciparum) and d) Those who responded only to antimalarials despite their peripheral smears being negative for malarial parasite. Complete history, clinical examination, relevant investigations and treatment given were recorded and findings were analyzed using statistical tests.

Results: Out of 100 cases reviewed, 53 had P.vivax malaria, 20 had P.falciparum, 1 had mixed infection (both vivax and falciparum) and 26 patients had clinical features suggestive of malaria (fever with chills, malaise, pallor, hepatosplenomegaly) with their peripheral smears being negative for malarial parasite but responded only to single dose of antimalarials. The average age of presentation of vivax malaria was 6.9 ±3.6 years and of falciparum was 7.0± 3.5 years. The average duration of hospital stay was 5.3 ± 3.6 days for P.vivax and 5.4 ± 2.9 days for P.falciparum. Cerebral malaria, splenomegaly were seen more in falciparum; whereas respiratory problems, severe anemia, thrombocytopenia and low blood pressure were similar in both vivax and falciparum malaria. Seventy five percent of children with vivax and 55% of children with falciparum malaria responded to single dose of chloroquine only.

Conclusion: P. Vivax can also lead to unusual and serious complications thus defying its stereotype as a benign disease. Most of the prevalent strains of plasmodia are still sensitive to chloroquine monotherapy.
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