Analysis of correlation between the parasite density and clinical profile of malaria

Abstract

Malaria, an infectious disease caused by protozoans of the genus Plasmodium, continues to be a serious global health problem. Typically, a higher parasite count is associated with a more severe infection and increased mortality. Delay in diagnosis and treatment also contributes to the mortality. In India, transmission of malaria is low and seasonal.Due to this unstable endemicity of the disease, we hypothesized that in our patients with malaria, morbidity and mortality will occur at lower parasitaemia levels compared to highly endemic areas. Therefore, we conducted this study at our tertiary care centre to find out correlation between parasite density and clinical profile of malaria. This observational, hospital based, cross- sectional study was carried out to find the correlation between parasite density and clinical profile of malaria in department of Pediatrics, Maharana Bhupal Government hospital, Udaipur for one year (April 21 to March 2022) duration. A total of 96 children aged 1 month to 18 years of age were enrolled. The most common presenting feature was fever (100%) followed by nausea and vomiting (68.8%) followed by headache (43.7%), jaundice (31.3%) and pain abdomen (29.2%). 60.4% patients had parasite density of less than 50,000 followed by 20.8% with below 1 lakh parasite density, 14.6% with density between 1 to 2 lakhs and remaining with higher parasite density. Maximum parasite density (more than 1 lakh/µl) was observed among P. falciparum patients, followed by mixed infection (1-2 lakhs/µl) patients. Correlation of clinical profile and parasite density revealed that as the parasite density increased there was increased in number of patients with headache, impaired consciousness, convulsions, and oliguria. High parasite density was associated with severe clinical illness and deranged laboratory parameters. As parasite density is very sensitive index, preparation of good quality peripheral blood film and proper assessment (parasite density) can help to assess the disease severity and outcome. High parasitaemia can be prevented by general measures in the form of proper education, good sanitation, and good awareness about the use of anti-larval activity.