BACKGROUND Malaria is a significant cause of morbidity and mortality in adults and children. Plasmodium falciparum is the primary cause of severe malaria, but recently Plasmodium vivax is also recognized to cause severe malaria-associated morbidity and mortality. The study focuses on determining the mortality related to severity parameters in individuals under 12 years and their critical presentation in P.vivax malaria-infected children. METHODS A prospective cross-sectional hospital-based study was conducted at Safdarjung Hospital, New Delhi, and ICMR-NIMR, New Delhi. All clinically suspected cases were admitted for screening. Exclusion criteria (rapid malaria antigen test, microscopy and medication history) were applied to all the admitted patients (n = 221) to obtain P.vivax patients only. Patients aged ≤ 12 years were included in the study. DNA was extracted from dried blood spots and amplified by nested PCR, followed by visualization on gel electrophoresis. RESULT A total of 221 clinically suspected cases of malaria were screened for P.vivax. After implementing various exclusion criteria, 45/221 cases were enrolled for the study, among which 44.4% (20/45) of children had the symptoms of severe malaria in terms of cerebral malaria, thrombocytopenia, anemia, pancytopenia, acute respiratory distress syndrome and hemophagocytic lymphohistiocytosis. CONCLUSION Plasmodium vivax mono-infection can cause severe manifestation and must be treated as P.falciparum without any delay because it may lead to increased morbidity and mortality. A changing trend in clinical symptoms has shown in P.vivax which was an earlier phenomenon of P.falciparum.

中文翻译：

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印度北部三级护理中心儿童间日疟原虫疟疾的临床特征和严重程度趋势。

背景技术疟疾是成人和儿童发病和死亡的重要原因。恶性疟原虫是严重疟疾的主要原因，但最近间日疟原虫也被认为会导致严重的疟疾相关发病率和死亡率。该研究的重点是确定 12 岁以下个体与严重程度参数相关的死亡率及其在间日疟原虫感染儿童中的关键表现。方法 在新德里 Safdarjung 医院和新德里 ICMR-NIMR 进行了一项基于医院的前瞻性横断面研究。所有临床疑似病例均被收治进行筛查。排除标准（快速疟疾抗原检测、显微镜检查和用药史）适用于所有入院患者（n = 221），仅获得间日疟原虫患者。年龄≤12岁的患者被纳入该研究。从干燥的血斑中提取 DNA，通过巢式 PCR 进行扩增，然后在凝胶电泳上进行可视化。结果 共对 221 例临床疑似疟疾病例进行了间日疟筛查。实施各种排除标准后，共纳入45/221例病例，其中44.4%（20/45）的儿童存在严重疟疾症状，包括脑型疟、血小板减少、贫血、全血细胞减少、急性呼吸窘迫综合征和噬血细胞性淋巴组织细胞增多症。结论间日疟原虫单一感染可引起严重症状，必须立即按恶性疟进行治疗，因为它可能导致发病率和死亡率增加。间日疟原虫的临床症状有变化趋势，这是恶性疟原虫的早期现象。