Introduction: Malaria continues to be one of the most important cause of fever and related sufferings of human beings. While nearly eliminated from many countries like United states, Canada, Europe, and Russia, it still remains a heavy burden on tropical countries despite continued preventive strategies. In recent times Malaria is presenting new challenges in terms of changing clinical profile especially p.vivax infection causing severe malaria thereby defying early diagnosis and so the early institution of antimalarial therapy.

Aims and Objectives: Evaluation of clinical profile and its complication will assist in early recognition of malaria helping timely treatment thereby reducing the morbidity and mortality and so the present study is undertaken.

Materials and Methods: 96 patients were enrolled from indoor and outdoor section of Magadh medical college hospital, Gaya. Rapid tests and peripheral blood smear examination used for diagnosis of malaria. Detailed clinical examination done and presenting clinical features noted, routine and specific lab. Investigation done, proper treatment instituted and regular follow up done. WHO criteria utilized for defining sever malaria. Statistical data analysed with 2016 Microsoft Excel.

Results: 54% suffered p.vivax infection, 47% from p. falciparum and 9% from mixed infection. More than 30% patients presented with uncommon clinical features , 8.6% showed warning sign , 31% developed severe malaria out of which P vivax contrary to the usual belief also developed  complication. 3 patients with more than one complication died despite best treatment.

Discussion: The burden of malaria varies in different zones of India so also the proportion of p. vivax and p. falciparum. P. vivaxdominates in Magadh zone of Bihar. Cough, severe headache, severe vomiting, abdominal pain, malena, oliguria are some of the uncommon presenting features recognized in the present study. Cerebral malaria, severe hypotension, ARDS were found to be the important cause of mortality as also reported from other studies.

Conclusion: Malaria remains a major public health problem. Changing clinical profile and increasing virulence of p. vivax is a matter of concern. Acknowledging these patterns helps in early diagnosis and better outcome.

Keywords: Malaria, Complications, prevalence, clinical profile.

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Dr Pramod Kumar Sinha

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