Clinical and epidemiological characterization of severe Plasmodium vivax malaria in Gujarat, India

Virulence

Ranvir Singh¹  Kamlesh J. Upadhyay¹  Ankita J. Patel¹  Suchi Tyagi¹  Jaykumar M. Joshi¹  Asha Shah¹  Anna Maria van Eijk²  Jane M. Carlton²  Steven A. Sullivan²  Himanshu Gupta³  Samuel C. Wassmer³  Anupkumar R. Anvikar⁴ 

[1] Byramjee Jeejeebhoy Medical College (BJMC), Civil Hospital, Ahmedabad, Indi;Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, US;Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, U;Indian Council of Medical Research (ICMR), National Institute of Malaria Research, New Delhi, Indi;Indian Council of Medical Research (ICMR), National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Indi;

关键词: Severe malaria;    Plasmodium vivax;    Gujarat;    India;    malaria elimination;   

DOI  :  10.1080/21505594.2020.1773107

来源: Taylor & Francis

【 摘 要 】

The mounting evidence supporting the capacity of Plasmodium vivax to cause severe disease has prompted the need for a better characterization of the resulting clinical complications. India is making progress with reducing malaria, but epidemics of severe vivax malaria in Gujarat, one of the main contributors to the vivax malaria burden in the country, have been reported recently and may be the result of a decrease in transmission and immune development. Over a period of one year, we enrolled severe malaria patients admitted at the Civil Hospital in Ahmedabad, the largest city in Gujarat, to investigate the morbidity of severe vivax malaria compared to severe falciparum malaria. Patients were submitted to standard thorough clinical and laboratory investigations and only PCR-confirmed infections were selected for the present study. Severevivax malaria (30 patients) was more frequent than severe falciparum malaria (8 patients) in our setting, and it predominantly affected adults (median age 32 years, interquartile range 22.5 years). This suggests a potential age shift in anti-malarial immunity, likely to result from the recent decrease in transmission across India. The clinical presentation of severe vivax patients was in line with previous reports, with jaundice as the most common complication. Our findings further support the need for epidemiological studies combining clinical characterization of severe vivax malaria and serological evaluation of exposure markers to monitor the impact of elimination programmes.

【 授权许可】

CC BY