The aim of this study was to assess the clinical profile, severity and complications of patients suffering from malaria in Mangaluru, a southwestern coastal city in India. A total of 579 patients, who were treated at the District Wenlock Hospital, Mangaluru, and 168 healthy controls were recruited in this study. The clinical profile, haematological and biochemical parameters, and disease complications were assessed. The majority of patients were treated as outpatients and patients who had severe clinical conditions were admitted to the hospital for treatment and supportive care. Among the total 579 patients recruited in this study, the distribution of P. vivax, P. falciparum and mixed infections were 364 (62.9%), 150 (25.9%) and 65 (11.2%), respectively. Among these, 506 (87.4%) had mild malaria, whereas 73 (12.6%) had severe malaria. Overall, the clinical features and severity of malaria in P. vivax and mixed infection patients were comparable to P. falciparum patients, albeit with some significant differences. The clinical complications in severe malaria cases included thrombocytopenia (50.7%), metabolic acidosis (30.1%), severe anaemia (26.0%), jaundice (21.9%), hepatic dysfunction (15.1%), acute renal failure (6.8%), haematuria (8.2%), hypotension (9.6%), cerebral malaria (1.4%) and acute respiratory distress syndrome (1.4%). All the patients with severe malaria recruited in our study were successfully treated and discharged. Majority of patients had mild malaria, likely due to seeking treatment soon after experiencing symptoms and/or having preexisting immune protection. However, a significant number of patients had severe malaria and required hospital admission indicating that there is a substantial need for creating awareness among vulnerable immigrant population. Implementing effective surveillance and vector control measures in malaria hotspot locations in the city and educating people about preventive measures are likely to reduce the malaria burden in this endemic region.
Mangaluru P. vivaxP. falciparumMalaria Clinical features Haematological parameters Hepatic dysfunction
National Vector Borne Disease Control Program
white blood cells
red blood cells
mean platelet volume
platelet distribution width
acute respiratory distress syndrome
systolic blood pressure
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The authors thank the study participants for their consent to participate in the study. We thank Dr. Rajeshwari Devi, District medical officer and superintendent of District Wenlock Hospital for her support and guidance, Dr. Arun Kumar, District Vector Borne Disease Control Programme officer, Dakshina Kannada, for his support and the Mangalore City Corporation Health officials for their kind help to conduct the study.
This work was supported by the Grant D43 TW008268 from the Fogarty International Center of the National Institutes of Health, USA, under the Global Infectious Diseases Program. The funders had no role in study design, data collection, and analysis, decision to publish or preparing the manuscript.
Compliance with ethical standards
Ethical approval and consent to participate
The ethics committee of Kuvempu University, Shivamogga, Karnataka, India; the central ethics committee of NITTE University, Mangaluru and the Institutional Review Board of the Pennsylvania State University College of Medicine, Hershey, USA, PA, have approved this study. Informed written consent was obtained from all the study participants
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
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