Volume 100, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Dakshina Kannada district in the Southwestern region of Karnataka state, India, including Mangaluru city is endemic to malaria. About 80% of malaria infections in Mangaluru and its surrounding areas are caused by and the remainder is due to . Malaria-associated clinical complications significantly occur in this region. Here, we report the pathological conditions of 41 cases of fatal severe malaria, admitted to the district government hospital in Mangaluru city during January 2013 through December 2016. The results of clinical, hematological, and biochemical analyses showed that most of these severe malaria cases were associated with thrombocytopenia, anemia, metabolic acidosis, acute respiratory distress, and single or multi-organ dysfunction involving liver, kidney, and brain. Of the 41 fatal malaria cases, 24, 10, and seven patients had , , and and mixed infections, respectively. These data suggest that besides that is known to extensively cause severe and fatal malaria illnesses, causes fatal illnesses substantially in this region, an observation that is consistent with recent findings in other regions.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI, , 2005. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 434: 214217. [Google Scholar]
  2. WHO, 2017. World Malaria Report 2017. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/malaria/publications/world-malaria-report-2017/en/. Accessed November 29, 2017. [Google Scholar]
  3. Guerra CA, Snow RW, Hay SI, , 2006. Mapping the global extent of malaria in 2005. Trends Parasitol 22: 353358. [Google Scholar]
  4. Sachs J, Malaney P, , 2002. The economic and social burden of malaria. Nature 415: 680685. [Google Scholar]
  5. Kumar A, Valecha N, Jain T, Dash AP, , 2007. Burden of malaria in India: retrospective and prospective view. Am J Trop Med Hyg 77: 6978. [Google Scholar]
  6. Dash AP, Valecha N, Anvikar AR, Kumar A, , 2008. Malaria in India: challenges and opportunities. J Biosci 33: 583592. [Google Scholar]
  7. Jha P, Gajalakshmi V, Gupta PC, Kumar R, Mony P, Dhingra N, Peto R, , 2006. Prospective study of one million deaths in India: rationale, design, and validation results. PLoS Med 3: e18. [Google Scholar]
  8. Anvikar AR, Shah N, Dhariwal AC, Sonal GS, Pradhan MM, Ghosh SK, Valecha N, , 2016. Epidemiology of Plasmodium vivax malaria in India. Am J Trop Med Hyg 95 (Suppl 6): 108120. [Google Scholar]
  9. Das A, 2012. Malaria in India: the center for the study of complex malaria in India. Acta Trop 121: 267273. [Google Scholar]
  10. Joshi H, Prajapati SK, Verma A, Kang’a S, Carlton JM, , 2008. Plasmodium vivax in India. Trends Parasitol 24: 228235. [Google Scholar]
  11. Cox-Singh J, Davis TME, Lee K-S, Shamsul SSG, Matusop A, Ratnam S, Rahman HA, Conway DJ, Singh B, , 2008. Plasmodium knowlesi malaria in humans is widely distributed and potentially life threatening. Clin Infect Dis 46: 165171. [Google Scholar]
  12. Choudhury DS, , 1985. Distribution of species of human malarial parasites in India. Indian J Pediatr 52: 257260. [Google Scholar]
  13. Trampuz A, Jereb M, Muzlovic I, Prabhu RM, , 2003. Clinical review: severe malaria. Crit Care 7: 315323. [Google Scholar]
  14. Miller LH, Good MF, Milon G, , 1994. Malaria pathogenesis. Science 264: 18781883. [Google Scholar]
  15. Mackintosh CL, Beeson JG, Marsh K, , 2004. Clinical features and pathogenesis of severe malaria. Trends Parasitol 20: 597603. [Google Scholar]
  16. Beg MA, Khan R, Baig SM, Gulzar Z, Hussain R, Smego RA, Jr., 2002. Cerebral involvement in benign tertian malaria. Am J Trop Med Hyg 67: 230232. [Google Scholar]
  17. Kochar DK, Das A, Kochar SK, Saxena V, Sirohi P, Garg S, Kochar A, Khatri MP, Gupta V, , 2009 Severe Plasmodium vivax malaria: a report on serial cases from Bikaner in northwestern India. Am J Trop Med Hyg 80: 194198. [Google Scholar]
  18. Ketema T, Bacha K, , 2013. Plasmodium vivax associated severe malaria complications among children in some malaria endemic areas of Ethiopia. BMC Public Health 13: 637. [Google Scholar]
  19. Kochar DK, Saxena V, Singh N, Kochar SK, Kumar SV, Das A, , 2005. Plasmodium vivax malaria. Emerg Infect Dis 11: 132134. [Google Scholar]
  20. Shaikh S, Memon H, Iohano B, Shaikh A, Ahmed I, Baird JK, , 2012. Severe disease in children hospitalized with a diagnosis of Plasmodium vivax in south-eastern Pakistan. Malar J 11: 144. [Google Scholar]
  21. Sharma S, Aggarwal KC, Deswal S, Raut D, Roy N, Kapoor R, , 2013. The unusual presentation of a usual organism–the changing spectrum of the clinical manifestations of Plasmodium vivax malaria in children: a retrospective study. J Clin Diagn Res. 7: 19641967. [Google Scholar]
  22. Fitri LE, Sardjono TW, Hermansyah B, Candradikusuma D, Berens-Riha N, , 2013. Unusual presentation of vivax malaria with anaemia, thrombocytopenia, jaundice, renal disturbance, and melena: a report from Malang, a nonendemic area in Indonesia. Case Rep Infect Dis 2013: 686348. [Google Scholar]
  23. Quispe AM, Pozo E, Guerrero E, Durand S, Baldeviano GC, Edgel KA, Graf PCF, Lescano AG, , 2014. Plasmodium vivax hospitalizations in a monoendemic malaria region: severe vivax malaria? Am J Trop Med Hyg 91: 1117. [Google Scholar]
  24. Dayanand KK, Punnath K, Chandrashekar V, Achur RN, Kakkilaya SB, Ghosh SK, Kumari S, Gowda DC, , 2017. Malaria prevalence in Mangaluru city area in the southwestern coastal region of India. Malar J. 16: 492. [Google Scholar]
  25. WHO, 2000. Severe falciparum malaria. World Health Organization, communicable diseases cluster. Trans R Soc Trop Med Hyg. 94 (Suppl 1): S1S90. [Google Scholar]
  26. Baird JK, , 2013. Evidence and implications of mortality associated with acute Plasmodium vivax malaria. Clin Microbiol Rev 26: 3657. [Google Scholar]
  27. Dhingra N, Jha P, Sharma VP, Cohen AA, Jotkar RM, Rodriguez PS, Bassani DG, Suraweera W, Laxminarayan R, Peto R, , 2010. Adult and child malaria mortality in India: a nationally representative mortality survey. Lancet 376: 17681774. [Google Scholar]
  28. Bhatia R, Rastogi RM1, Ortega L, , 2013. Malaria successes and challenges in Asia. J Vector Borne Dis 50: 239247. [Google Scholar]
  29. Basnyat B, , 2011. Malaria-attributed death rates in India. Lancet. 377: 993. [Google Scholar]
  30. Naing C, Whittaker MA, Nyunt Wai V, Mak JW, , 2014. Is Plasmodium vivax malaria a severe malaria?: a systematic review and meta-analysis. PLoS Negl Trop Dis 8: e3071. [Google Scholar]
  31. Price RN, Douglas NM, Anstey NM, , 2009. New developments in Plasmodium vivax malaria: severe disease and the rise of chloroquine resistance. Curr Opin Infect Dis 22: 430435. [Google Scholar]
  32. Anstey NM, Douglas NM, Poespoprodjo JR, Price RN, , 2012. Plasmodium vivax: clinical spectrum, risk factors and pathogenesis. Adv Parasitol 80: 151201. [Google Scholar]

Data & Media loading...

  • Received : 03 Jan 2018
  • Accepted : 10 Oct 2018
  • Published online : 10 Dec 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error