Malaria Severity in Mangaluru City in the Southwestern Coastal Region of India

Kiran K. Dayanand Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India;
Department of Biochemistry, Kuvempu University, Shankaraghatta, India;

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Punnath Kishore Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India;
Department of Biochemistry, Kuvempu University, Shankaraghatta, India;

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Valleesha Chandrashekar Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India;
Department of Biochemistry, Kuvempu University, Shankaraghatta, India;

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Rajeshwara N. Achur Department of Biochemistry, Kuvempu University, Shankaraghatta, India;

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Susanta K. Ghosh Department of Biological Control, National Institute of Malaria Research, Poojanahalli, India;

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Srinivas B. Kakkilaya Light House Polyclinic, Mangaluru, India;

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Suchetha N. Kumari Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India;

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Satyanarayan Tiwari Department of Biological Control, National Institute of Malaria Research, Poojanahalli, India;

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Archith Boloor Department of Medicine, Kasturba Medical College, Mangalore, India;

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Rajeshwari Devi Wenlock District Hospital, Mangaluru, India;

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D. Channe Gowda Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania

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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 Plasmodium vivax and the remainder is due to Plasmodium falciparum. 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 P. vivax, P. falciparum, and P. vivax and P. falciparum mixed infections, respectively. These data suggest that besides P. falciparum that is known to extensively cause severe and fatal malaria illnesses, P. vivax causes fatal illnesses substantially in this region, an observation that is consistent with recent findings in other regions.

Author Notes

Address correspondence to D. Channe Gowda, Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, 500 University Dr., Hershey, PA 17033. E-mail: cdg13@psu.edu

Financial support: This work was supported by D43 TW008268 the Fogarty International Center of the National Institutes of Health under the Global Infectious Diseases Program.

Authors’ addresses: Kiran K. Dayanand, Punnath Kishore, and Valleesha Chandrashekar, Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India, and Department of Biochemistry, Kuvempu University, Shankaraghatta, India, E-mails: kirankumar91284@gmail.com, kishoresbioworld@gmail.com, and Vallesha.nc@gmail.com. Rajeshwara N. Achur, Department of Biochemistry, Kuvempu University, Shankaraghatta, India, E-mail: rajachur@gmail.com. Susanta K. Ghosh and Satyanarayan Tiwari, Department of Biological Control, National Institute of Malaria Research, Poojanahalli, India, E-mails: ghoshnimr@gmail.com and snt57.nimr@gmail.com. Srinivas B. Kakkilaya, Light House Polyclinic, Spandana Centre for Metabolic Medicine, Mangalore, India, E-mail: skakkilaya@gmail.com. Suchetha N. Kumari, Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India, E-mail: kumari.suchetha@gmail.com.Archith Boloor, Department of Medicine, Kasturba Medical College, Mangalore, India, E-mail: archith_boloor@gmail.com. Rajeshwari Devi, Medical Administration, Wenlock District Hospital, Mangaluru, India, E-mail: dsdkannada@gmail.com. D. Channe Gowda, Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, E-mail: cdg13@psu.edu.

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