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Clinical features and haematological parameters among malaria patients in Mangaluru city area in the southwestern coastal region of India

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Abstract

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.

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Availability of data and materials

The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

NVBDCP:

National Vector Borne Disease Control Program

MM:

mild malaria

SM:

severe malaria

WBCs:

white blood cells

RBCs:

red blood cells

Hb:

haemoglobin

HCT:

haematocrit

MPV:

mean platelet volume

PDW:

platelet distribution width

AST:

aspartate transaminase

ALT:

alanine transaminase

CM:

cerebral malaria

ARDS:

acute respiratory distress syndrome

SBP:

systolic blood pressure

SMS:

short message service

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Acknowledgements

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.

Funding

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.

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Authors and Affiliations

  1. Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India

    Kishore Punnath, Kiran K. Dayanand, Valleesha N. Chandrashekar & Suchetha N. Kumari

  2. Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka, India

    Kishore Punnath, Kiran K. Dayanand, Valleesha N. Chandrashekar & Rajeshwara N. Achur

  3. Light House Polyclinic, Light House Hill Road, Mangaluru, Karnataka, India

    Srinivas B. Kakkilaya

  4. Department of Molecular Parasitology, ICMR-National Institute of Malaria Research, Poojanahalli, Bangalore, India

    Susanta K. Ghosh & Benudhar Mukhi

  5. Department of Biostatistics and Bioinformatics, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, USA

    Vishal Midya

  6. Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, USA

    D. Channe Gowda

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  1. Kishore Punnath
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  2. Kiran K. Dayanand
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  3. Valleesha N. Chandrashekar
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  4. Rajeshwara N. Achur
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  5. Srinivas B. Kakkilaya
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  7. Benudhar Mukhi
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  8. Vishal Midya
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  9. Suchetha N. Kumari
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  10. D. Channe Gowda
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Corresponding authors

Correspondence to Rajeshwara N. Achur or D. Channe Gowda.

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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

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Informed consent was obtained from all individual participants included in the study.

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Punnath, K., Dayanand, K.K., Chandrashekar, V.N. et al. Clinical features and haematological parameters among malaria patients in Mangaluru city area in the southwestern coastal region of India. Parasitol Res 119, 1043–1056 (2020). https://doi.org/10.1007/s00436-019-06540-2

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