Epidemiology and clinical outcomes of severe Plasmodium vivax malaria in India - 12/05/21
Highlights |
• | A systematic review/meta-analysis on severe vivax malaria in India was undertaken. |
• | The pooled proportion of severe vivax malaria was 29.3%. |
• | Jaundice and severe thrombocytopenia were the main severity signs. |
• | Myocarditis was the commonest atypical severity condition. |
• | The mortality rate in severe vivax malaria ranged from 0 to 12.9%. |
Summary |
Objectives |
: A systematic review and meta-analysis (SR-MA) of the available Indian literature on severe vivax malaria (SVM) was undertaken.
Methods |
: Relevant studies in eight electronic databases were retrieved and reviewed. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. The methodological quality of the studies included in the MA was assessed.
Results |
: Overall, 162 studies were included in the work. The pooled proportion of SVM was 29.3%. The main severity signs/symptoms seen in SVM were jaundice, severe thrombocytopenia (ST), multi-organ dysfunction, and severe anaemia with pooled proportion of 37.4%, 37.2%, 24.2% and 20.4%, respectively. P. falciparum was inducing 6% less ST (RR = 0.94, 95% CI 0.5–1.5, I2 = 77.87%), 10% less thrombocytopenia (RR = 0.9, 95% CI 0.7–1.1, I2 = 91.68%) and 20% less DIC (RR = 0.8, 95% CI 0.3–1.9, I2 = 0%) than P. vivax. An atypical condition like myocarditis, was most commonly observed among the studied SVM cases. The mortality rate in SVM cases ranged from 0 to 12.9% among hospital patients with P. vivax mono-infections.
Conclusions |
: The present SR-MA provides evidence for P. vivax as the etiologic agent of severe malaria leading to deaths in few cases as seen recently in India. However, research gaps outlined here emphasise the need for further studies on SVM in pregnancy, SVM in drug resistance and correlations with cytoadherence in disease severity due to P. vivax.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Keywords : India, Meta-analysis, Plasmodium vivax, Severe malaria, Systematic review
Abbreviations : ACT, ARDS, ART, BCS, BUN, CM, crt, CQ, DIC, DOX, GCS, G6PD, G6PD-d, Hb, Hct, HELLP, JBI, QC, MA, mdr, NA, PBF, PCR, PE, PP, PRISMA, PQ, RBC, RD, QBC, OR, RDT, RR, SD, SP, SBP, Scr, SVM, SR, sSA, ST, UT, vir, WHO
Plan
Vol 82 - N° 6
P. 231-246 - juin 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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