Department of Medicine, Himalayan Institute of Medical Sciences, HIHT University, Jolly Grant, Doiwala, Dehradun, Uttarakhand 248140, India.
Acta Trop. 2011 Feb;117(2):82-5. doi: 10.1016/j.actatropica.2010.10.001. Epub 2010 Oct 11.
despite the high prevalence of Plasmodium vivax (P vivax) malaria, research into its complications has lagged disproportionately as compared to Plasmodium falciparum (P falciparum) malaria.
the present retrospective observational study was conducted on cases with P vivax mono-infection presenting with severe malaria on the basis of one or more criteria as per the World Health Organization guidelines being used for severe falciparum malaria in children, as well as other manifestations been classified as complicated malaria, during an outbreak of malaria in a single tertiary referral hospital of north India.
seventy-four patients of acute malaria presented during the outbreak, of which 50 cases with P vivax mono-infection were included for the study. Complicated malaria was diagnosed in 41/50 cases, with thrombocytopenia being the commonest manifestation. Other presentations of severe malaria in our patients were liver dysfunction (with or without jaundice) 31/50 cases, respiratory involvement 14/50 cases, renal impairment 11/50 cases, circulatory collapse (Shock) 8/50 cases, severe anaemia 3/50 cases and central nervous system (CNS) involvement 2/50 cases.
the term "benign tertian malaria" no longer holds true for P vivax mono-infection. The authors wish to open a new front for researches on the possible genotypic abnormalities that the parasite or its carrier might have acquired over decades and has transformed into a species with the malignant potential of P falciparum.
尽管间日疟原虫（P vivax）疟疾的发病率很高，但与恶性疟原虫（P falciparum）疟疾相比，对其并发症的研究却不成比例地滞后。
本回顾性观察研究是在印度北部一家三级转诊医院发生疟疾暴发期间，根据世界卫生组织（WHO）用于儿童重症恶性疟的指南中使用的一个或多个标准，对表现为严重疟疾的单纯间日疟原虫感染病例进行的。此外，还将其他表现归类为复杂疟疾。
暴发期间有 74 例急性疟疾患者，其中 50 例单纯间日疟原虫感染病例纳入研究。41/50 例诊断为复杂疟疾，血小板减少症是最常见的表现。我们的患者中其他严重疟疾的表现为肝功能障碍（伴或不伴黄疸）31/50 例，呼吸受累 14/50 例，肾功能损害 11/50 例，循环衰竭（休克）8/50 例，严重贫血 3/50 例和中枢神经系统（CNS）受累 2/50 例。
单纯间日疟原虫感染不再适用于“良性间日疟”一词。作者希望为寄生虫或其携带者可能在几十年中获得并转化为具有恶性疟原虫恶性潜力的物种的潜在基因型异常的研究开辟新的领域。
