Changing clinical profile of malaria in Indian children

Summary

Plasmodium_vivaxMalaria remains a major public health problem in India and is considered to be an important cause of morbidity due to infectious disease in Indian children. A significant number of childhood deaths can be prevented by timely identification and management of malaria. Severe malaria is most commonly caused in our country by infection with Plasmodium falciparum (Pf) and Plasmodium vivax (Pv), two species of protozoan parasites. Previously, Pf was considered to be responsible for severe malaria and malaria mortality. However, recent literature seems to suggest that Pv is the more significant causative organism for severe malaria in the Indian context.

Key Point: From the currently available recent literature it was found that a significant proportion of severe malaria morbidity is caused by P. vivax monoinfection in the region where both P. Vivax and P. falciparum coexist. Thrombocytopenia, respiratory complications, renal dysfunctions, hepatitis and MODS are found to be some of the most common causes of morbidity in children with malaria. In Indian studies, P. vivax was found to be associated with more severe clinical features and morbidity, as compared with P. falciparum malaria. Additionally, P. vivax malaria was found to occur most commonly in children under 5 years of age. It will be important to ensure that P. vivax receives appropriate attention by the malaria control program in our country.

Malaria burden in Indian children

Malaria globally afflicts a large number of countries and territories in tropical and subtropical regions. Almost half of the world population lives in malaria-prone zones. Over 1 million people are dying due to malaria every year [1]. According to a UNICEF report, 8% of children’s deaths worldwide occurred due to malaria infection [2]. From all of the malaria cases reported from southeast Asia, three-fourths are contributed by India alone. The earning population was found to be the most commonly affected by infection. Complicated malaria in pregnancy can lead to anemia, abortions, low birth weight in neonates, stillbirths, and maternal mortality. Aside from preventing these outcomes, malaria prevention has a significant economic benefit as well. As noted by Ashwani K et al., “Cost-benefit analysis suggests that each Rupee invested by the National Malaria Control Program pays a rich dividend of 19.7 Rupees” [3].
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This entry was posted in Infectious Disease, Pediatrics and tagged , , . Volume: .

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