Plasmodium vivax hospitalizations in a monoendemic malaria region: Severe vivax malaria?

Abstract

Severe malaria caused byPlasmodium vivaxis no longer considered rare. To describe its clinicalfeatures, we performed a retrospective case control study in the subregion of Luciano Castillo Colonna, Piura,Peru, an area with nearly exclusive vivax malaria transmission. Severe cases and the subset of critically ill caseswere compared with a random set of uncomplicated malaria cases (1:4). Between 2008 and 2009, 6,502 malariacases were reported, including 106 hospitalized cases, 81 ofwhich fit the World Health Organization definition forsevere malaria. Of these 81 individuals, 28 individuals were critically ill (0.4%, 95% confidence interval=0.2–0.6%)with severe anemia (57%), shock (25%), lung injury (21%), acute renal failure (14%), or cerebral malaria (11%).Two potentially malaria-related deaths occurred. Compared with uncomplicated cases, individuals critically ill wereolder (38 versus 26 years old,P<0.001), but similar in other regards. Severe vivax malaria monoinfection withcritical illness is more common than previously thought