Table 3.
Epidemiological and clinical characteristics of P. vivax patients admitted to tertiary care centers in Brazil and India, with the diagnosis of severe malaria according to WHO criteria
| Manaus (Brazil) | Bikaner (India) | P | |
|---|---|---|---|
| Demographic and epidemiological characteristics | |||
| Female sex | 16/40 (40.0%) | 98/157 (62.4%) | 0.010 |
| Age <12 years old | 7/40 (17.5%) | 3/157 (1.9%) | <0.001 |
| First malarial infection | 25/40 (62.5%) | 149/150 (99.3%) | <0.001 |
| Pregnancy (among females of reproductive age) | 11/16 (68.8%) | 67/98 (68.4%) | 0.976 |
| Clinical characteristics | |||
| Severe anemia (Hb < 5 g/dl if age < 12 and Hb < 7 if age ≥ 12) |
19/40 (47.5%) | 83/157 (53.2%) | 0.519 |
| Acute renal failure (Creatinine > 3 mg/dL and/or urinary output < 0.5 ml/kg/h for 6 hours) |
9/40 (22.5%) | 18/157 (11.5%) | 0.073* |
| Hyperlactatemia (lactate > 5 mmol/L) |
5/40 (15.2%) | 4/157 (2.6%) | 0.343* |
| Respiratory distress (PaO2/FiO2 ≤ 300 mmHg and/or bilateral opacities on X-ray) |
7/40 (17.5%) | 5/157 (3.2%) | 0.002* |
| Hypoglycemia (blood glucose < 40 mg/dL) |
4/40 (10.0%) | 1/157 (0.7%) | 0.001* |
| Shock (SBP > 90 mmHg refractory to fluid resuscitation) |
3/40 (7.6%) | 7/157 (4.6%) | 0.463* |
| DIC (prolonged aPTT, platelet < 50x109/L and elevated FDP) |
2/40 (5.0%) | 0/157 (0%) | 0.005* |
| Cerebral malaria (GCS ≤ 9 in adults or BCS ≤ 2 in children and/or repeated convulsions) |
1/40 (2.5%) | 5/157 (3.2%) | 0.817* |
| Two or more complications | 20/40 (50.0%) | 75/157 (47.8%) | 0.801 |
| Three or more complications | 5/40 (12.5%) | 16/157 (10.2%) | 0.673* |
| Presence of any other acute co-morbidity | 6/40 (15.0%) | 6/157 (0.6%) | <0.001* |
| Presence of any chronic co-morbidity | 14/40 (35.0%) | 4/157 (2.5%) | <0.001* |
| Death | 3/40 (7.5%) | 7/157 (4.4%) | 0.434* |
P-value obtained by chi-square test or Fisher test with the latter identified (*); Hb, hemoglobin; PaO2, partial pressure of arterial oxygen; FiO2, fraction of inspired oxygen; SBP, systolic blood pressure; DIC, disseminated intravascular coagulation; aPTT, activated partial thromboplastin time; FDP, fibrinogen degradation product; GCS, Glasgow Coma Scale; BCS, Blantyre Coma Scale.