Transition of Vivax Malaria from Benign to Malignant Clinical Profile: A Cause of Concern

This present research aimed to study hepatic dysfunction, renal dysfunction and prevalance of thrombocytopenia in children with malaria in tertiary care centre of Bundelkhand region. Children in the age groups of 1 to 15 yrs, whose peripheral smear were positive for malarial parasite were included in the study group from amongst those admitted in pediatric ward of tertiary care hospital in Jhansi. A detailed history and clinical examination was done, followed by investigations like hemogram, platelet count general blood picture, reticulocyte count, serum bilirubin, SGOT, SGPT, serum alkaline phosphatase, blood urea and serum creatinine. Raised level of SGPT, SGOT and total serum bilirubin were seen in 31%, 30% 53% respectively. In our study 11% of cases had raised level of blood urea or serum creatinine or both. Greatest affected group was 10-15 yrs in which 6 cases had increased urea and creatnine level. There were 88 cases (88%) in which platelet count was < 1.5 lac/Cu mm, among them P.falciparum cases were 47(47%) and P.vivax cases were 41(41%). Liver functions are commonly affected in malaria and liver dysfunction ranges from mild elevation of liver enzymes to the range of acute hepatitis . There was no significant difference in incidence of thrombocytopenia between vivax and falciparum cases. Mild renal impairement was present in a number of cases and it was noted that dehydration also plays role in the genesis of renal impairement in children with malaria