{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:55:25Z","timestamp":1788994525158,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"\n \n \n Background & objectives:<\/jats:italic>\n Previously there were reports from all over India about the changing spectrum of severe manifestations of\n Plasmodium falciparum<\/jats:italic>\n malaria. Consequently, the present retrospective study was conducted to compare the severity of malaria caused by\n P. falciparum<\/jats:italic>\n and\n P. vivax<\/jats:italic>\n during 2007\u201308 and 2017\u201318.\n <\/jats:p>\n \n Methods:<\/jats:italic>\n The present study was conducted on the patients admitted with severe malaria in a classified malaria ward of a tertiary care hospital in Bikaner, Rajasthan (Northwest India) during 2007\u201308 and 2017\u201318. It included adult patients of both sexes belonging to all age groups. The diagnosis was done by peripheral blood film (PBF), rapid diagnostic test (RDT), and validated by polymerase chain reaction (PCR). All patients were treated with intravenous oral quinine. The specific individual malaria complications registered in 2007\u201308 and 2017\u201318 were treated by following the standard WHO protocol.\n <\/jats:p>\n \n Results:<\/jats:italic>\n In 2007\u201308, severe manifestations caused by\n P. falciparum<\/jats:italic>\n were dominated by thrombocytopenia (25.98%) followed by jaundice (24.39%), multi-organ dysfunction (MODS) (16.66%), severe anemia (16.17%), cerebral malaria (5.39%), bleeding manifestation (3.92%) and shock (0.49%). While in the same year,\n P. vivax<\/jats:italic>\n associated clinical spectrum of complications were observed to be dominated by thrombocytopenia (26.47%) followed by jaundice (25.00%), MODS (14.70%), severe anemia (5.88%), cerebral malaria (5.88%), renal failure (4.41%), bleeding manifestation (2.45%), shock (0.98%) and acute respiratory distress syndrome (ARDS) (0.49%). However, in 2017\u201318, the clinical spectrum of malaria complications caused by both species has changed. Relative to\n P. falciparum<\/jats:italic>\n infections,\n P. vivax<\/jats:italic>\n individual complications like thrombocytopenia (51.78%) (\n p<\/jats:italic>\n <0.001) followed by jaundice (19.13%) (\n p<\/jats:italic>\n <0.001) and severe anemia (4.22%) (\n p<\/jats:italic>\n <0.05) were found to have increased significantly.\n <\/jats:p>\n \n Interpretation & conclusion:<\/jats:italic>\n Over the last decade there is an apparent spatial and temporal shift in the clinical manifestations of severe malaria caused by the both\n Plasmodium<\/jats:italic>\n species. As evident from the patient\u2019s data from 2007\u201308 and 2017\u201318, the severity is more inclined towards\n Plasmodium vivax<\/jats:italic>\n than\n Plasmodium falciparum<\/jats:italic>\n malaria. Moreover, individual\n P. falciparum-<\/jats:italic>\n associated complications were decreased significantly in the Bikaner region of Rajasthan, India.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0972-9062.342396","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T07:15:41Z","timestamp":1648710941000},"page":"259-264","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Changing pattern of severe manifestations of Plasmodium falciparum and Plasmodium vivax malaria"],"prefix":"10.4103","volume":"59","author":[{"given":"Jyoti","family":"Acharya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmesh","family":"Harwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-10-20240830","doi-asserted-by":"crossref","first-page":"e774","DOI":"10.1371\/journal.pntd.0000774","article-title":"The international limits and population at risk of Plasmodiumvivax transmission in 2009","volume":"4","author":"Guerra","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"key":"R2-10-20240830","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.pt.2009.06.004","article-title":"Why is it important to study malaria epidemiology in India?","volume":"25","author":"Singh","year":"2009","journal-title":"Trends Parasitol"},{"key":"R3-10-20240830","doi-asserted-by":"crossref","first-page":"194","DOI":"10.4269\/ajtmh.2009.80.194","article-title":"Severe Plasmodiumvivax malaria: a report on serial cases from Bikaner in northwestern India","volume":"80","author":"Kochar","year":"2009","journal-title":"Am J Trop Med Hyg"},{"key":"R4-10-20240830","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1093\/cid\/cis615","article-title":"Postmortem characterization of patients with clinical diagnosis of Plasmodiumvivax malaria: to what extent does this parasite kill?","volume":"55","author":"Lacerda","year":"2012","journal-title":"Clin Infect Dis"},{"key":"R5-10-20240830","first-page":"861","article-title":"The clinicopathologic manifestations of Plasmodiumvivax malaria in children: a growing menace","volume":"7","author":"Bhattacharjee","year":"2013","journal-title":"J Clin Diagn Res"},{"key":"R6-10-20240830","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1179\/2046905512Y.0000000012","article-title":"Plasmodiumvivax malaria admissions and risk of mortality in a tertiarycare children\u2019s hospital in North India. 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