Age-Related Manifestations of Malaria and Factors Associated with Type and Severity of Malaria

Abstract

To study age related manifestations, type and severity of malaria in children.Methods: Retrospective study of 30 malarial patients. Clinical features were analyzed as per age-groups, severity and type of malaria.Results: Mean age was 6.5±4 yrs ranging from 1-14 yrs. Male: female ratio was 2.3:1. Vomiting was common in children >10 yrs of age (p=0.03), anemia and splenomegaly were common in children <5 yrs of age (p=0.002 and p=0.025 respectively). Mean hemoglobin in children <5 yrs age was 7.19±2.21 gm% as compared to 8.55±3.34 gm% in 5-10 yrs and 11.14±2.18 gm% in >10 yrs (p=0.035). Plasmodium falciparum was seen in 7 (23.3%), p. vivax in 18 (60%) and mixed (falciparum+vivax) in 5 (16.7%) children. Mixed malaria was prevalent (100%) in children aged between 5-10 yrs (p=0.041). All patients with P. falciparum and mixed malaria had thrombocytopenia and hepatomegaly (p=0.048 and p=0.026 respectively). Thirteen (43.3%) children had severe malaria. Common features in severe malaria were thrombocytopenia (100%) and hepatomegaly (p=0.010 and p=0.047 respectively). In severe malaria, hemoglobin was lower (7.0+3.0 gm vs 9.4+2.5 gm%) (p=0.025) and serum creatinine was higher (0.9+0.3 vs 0.7+0.2 mg/dl) (p=0.019). Conclusion:In children <5 yrs, anemia and splenomegaly are common. In children between 5-10 yrs, mixed malaria is common whereas in >10 yrs vomiting is predominant. Falciparum and severe malaria are associated with hepatomegaly and thrombocytopenia.