Comparative Analysis Of Mortality Patterns Associated With Plasmodium Falciparum And Plasmodium Vivax In A Hyperendemic Region Of Bihar, India

Abstract

Plasmodium falciparum and Plasmodium vivax co-exist with Malaria in regions of India that are hyperendemic, imposing a high mortality burden and having a dissimilar impact on the severe disease outcomes. The proposed study has made a comparative evaluation of the patterns of species-specific mortality in the selected hyperendemic districts of Bihar using retrospective observational cohort design on the basis of regularly collected clinical and surveillance data. One thousand two hundred and eighty-four laboratory confirmed cases of malaria were studied comprising 742 cases of P. falciparum and 542 cases of P. vivax. Mortality was observed to be more in P. falciparum (8.2% than in P. vivax (3.3%), where death cases were at both ends of the age and mainly among patients who presented with diabetes complications. Multivariate logistic regression revealed that P. falciparum infection on its own was a significant predictor of death following the factors of age, sex, and severity of disease but IVs at presentation were shown to be the most significant factor of death. Even if the death rate related to P. vivax was less in absolute terms, the fact that fatal consequences did occur highlighted the fact that vivax malaria is not always benign when it comes to hyperendemic areas with limited resources. The observation shows the significance of species based risk stratification, early diagnosis, and prompt referral of severe malaria in order to minimize death caused by malaria in endemic countries like Bihar, India.