European Journal of Molecular & Clinical Medicine

Abstract

Malaria is one of the most widespread infections in the tropics, and also one of the most dangerous. There are four types of Plasmodium causing malaria of which Plasmodium vivax and falciparum are common in India. There is a huge burden of disease and it is responsible for increased mortality and morbidity. Due to paucity of research to quantify the severity and to predict the mortality risk of vivax malaria even though it affects multiple organ system during the course of the disease, this study was undertaken, to assess the severity of P. vivax malaria according to malaria severity score (MSS). The Aim of this study was to analyze the role of Malaria Severity Score (MSS) in predicting morbidity and mortality in patients affected by Plasmodium vivax infection.
Methods: This was a prospective observational study conducted in department of medicine from 1st December 2019 to 30th September 2021, in a tertiary care hospital in North India. All adult patients with age more than 18 years, with plasmodium vivax infection were included in the study. The diagnosis of malaria was made on thick and thin smear with malarial parasite identification and/or RDT (Rapid diagnostic test) kits. Organ dysfunction (OD) of each patient was assessed based on clinical and laboratory parameters and categorized into various levels of severity. Each level was translated into a score and Malaria Severity Score was calculated.
Results: A total 55 P. vivax positive patients were included in the study. Mean age was 37.53 years. There were 35(63.64%) males and 20(36.36%) females. Most common symptom was fever (98.18%) followed by yellowish discoloration of eyes (30.91%), vomiting (16.36%), generalized weakness (9.09%), headache (5.45%), cough (3.64%), loose stools (3.64%), abdominal pain (3.64%) and hemoptysis (3.64%). Significant association was found between jaundice and renal failure and mortality (p-0.00163) and between platelet count less than 80000 and mortality (p- 0.018). Mean MSS was 4.45 ± 3.77. Mortality was seen in 4(7.27%) patients.  Mean duration of hospital stay was 5.09 ± 2.22 days.
Conclusion: MSS >7 was a significant predictor of mortalityin P. vivax malaria patients (p <0.0001).