Clinical Spectrum of Plasmodium Vivax Malaria in Children Presenting to a Tertiary Care Hospital, Lahore

Abstract

Background: Malaria is endemic in Pakistan and physicians should be fully aware of varied clinical and laboratory manifestations of malaria in children to maintain high index of suspicion for diagnosis. Objective: To describe the clinical features and haematological investigations of children with Plasmodium Vivax malaria in a tertiary care hospital. Methods: This analytic cross-sectional study consisted of 83 children under15years of age. They had clinical features suggestive of malaria and blood films were positive for Plasmodium Vivax. Data were collected by non-probability convenient sampling technique and were analyzed by SPSS version 21. Results: Of 83 children, mean age was 5.3±4.4 years and 66% were males. All patients had fever (100%) associated with rigor and chills (94%), vomiting (73.5%) and abdominal pain (32.5%). Splenomegaly was found in 92.8%, pallor in 89%, hepatomegaly in 85% and jaundice in 25% children. It was observed that 77.1% of the children had anaemia with mean haemoglobin as 9.1±2.53 g/dL and 84% had thrombocytopenia with mean thrombocyte count as 114 ± 73×103/mm3. Red cell indices and haematocrit were below the normal limits. Splenomegaly was significantly associated with rigors/chills, vomiting, jaundice, abdominal pain and pallor (p <0.05). Hepatomegaly was found to has significant association with abdominal pain only (p <0.001). Conclusion: High grade fever with chills/rigors and vomiting along with hepatosplenomegaly were main clinical features of Plasmodium Vivax malaria. Anaemia and thrombocytopenia were most frequent haematological disturbances.