Discriminating Clinical and Biological Features in Malaria and Dengue Patients

  • Wajihullah Khan Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, India
  • Haytham A. Zakai Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
  • Khadija Khan Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, India
  • Sharba Kausar Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, India
  • Sana Aqeel Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, India
Keywords: Malaria, Dengue, Clinical features, Liver enzymes, Kidney markers

Abstract

Background: Malaria and dengue are the most widespread infectious diseases of tropical countries with an estimated 219 and 50 million cases globally. The aim of the proposed study was to find out discriminating clinical features of falciparum malaria and dengue.Method: Falciparum malaria was diagnosed by looking at the ring and gametocyte stages by microscopic examina­tion in Giemsa stained slides. Dengue was diagnosed by ELISA for dengue-specific IgM and IgG. Liver enzymes (AST and ALT) and kidney markers (creatinine and urea) were estimated by standard biochemical techniques.Result: AST and ALT showed similar rise in both, severe malaria and dengue patients but it was much pronounced in dengue haemorrhagic fever where it attained 3–4 folds increase. Creatinine and urea showed higher levels in den­gue compared to malaria. Thrombocytopenia (76.27%), convulsions (18.64%) and hepatic dysfunction (5.08%) were more prominent in dengue than that in malaria where these parameters were 50.89, 7.14 and 2.67%, respectively. Conversely, cases with anaemia, splenomegaly and jaundice were three times more in falciparum malaria. Acute renal failures and neurological sequelae were noticed in slightly higher number of dengue patients.   Conclusion: Thrombocytopenia and hepatic dysfunction were more common in dengue, while anaemia, splenomeg­aly, jaundice and convulsions were more frequent in falciparum malaria. Neurological sequelae and cases of acute renal failure were almost equal in both the infections.

References

World Health Organization (2009) Den-gue guidelines for diagnosis, treatment, prevention and control. TDR. Available at: http://www.who.int/tdr/publications/ documents/ dengue-diagnosis.pdf

Whitehorn J, Farrar J (2010) Dengue. Br Med Bul. 95: 161–173.

World Health Organisation (2012) World malaria report (2012) summary. Avail-able at: http://www.who.int/malaria/publica-tions/world_malaria_report_2012/en/index.html

Epelboin L, Boulle C, Ouar- Epelboin S, Hanf M, Dussart P, Djossou F, Na¬cher M, Carme B (2013) Discriminating malaria from dengue fever in endemic areas: clinical and biological criteria, prognostic score and utility of the C- reactive proteins: retrospective matched- pair study in French Gui-ana. PLoS Negl Trop Dis. 7(9): e2420.

Noisakran S, Perng GC (2008) Alter¬nate hypothesis on the pathogenesis of dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) in dengue virus infection. Exp Biol Med. (May¬wood). 233(4): 401–408.

de Souza LJ, Nogueira RM, Soares LC, Soares CE, Ribas BF, Alves FP, Vieira FR, Pessanha FE (2007) The im¬pact of dengue on liver function as evaluated by aminotransferase levels. Braz J Infect Dis. 11(4): 407–410.

Das BS (2008) Renal failure in ma¬laria. J Vector Borne Dis. 45: 83–97.

Ogbadoyi EO, Tsado RD (2009) Renal and hepatic dysfunction in malaria pa¬tients in Minna, North Central Ni-geria. OJHAS. 8(3): 1–6.

Onyesom I, Onyemakonor N (2011) Lev-el of parasitaemia and changes in some liver enzymes among malarial infected patients in Edo-Delta region of Nigeria. Curr Res J Biol Sci. 3: 78–81.

Wilkinson JH, Baron DN, Moss DW, Walker PG (1972) Standardization of clinical enzyme assays: a refer-ence method for aspartate and ala-nine trans¬aminase. J Clin Path. 25: 940-944.

Thomas L (1998) Clinical laboratory di-agnostics. TH-Books Verlagsgesell-schaft, Frankfurt, pp. 366–374.

Kaplan A (1965) Standard methods of clinical chemistry. Academic press,

New York, USA, pp. 245–256.

Wickramasinghe SN, Abdalla SH (2000) Blood and bone marrow changes in malaria. Baillieres Best Pract Res Clin Haemato. 13: 277–299.

Jadhav UM, Patkar VS, Kadam NN (2004) Thrombocytopaenia in malar-ia-correlated with type and severity of malaria. J Assoc Physicians India. 52: 615–618.

Rodriguez-Morales AJ, Sanchez E, Var-gas M, Piccolo C, Colina R, Arria M (2006) Anaemia and thrombocyto-penia in children with Plasmodium vivax malaria. J Trop Pediatr. 52(1): 49–51.

Riaz MM, Mumtaz K, Khan MS, Patel J, Tariq M, Hilal H, Siddiqui SA, Shezad F (2009) Outbreak of dengue fever in Karachi 2006: a clinical per-spective. J Pak Med Assoc. 59(6): 339–344.

Mehra N, Patel A, Abraham G, Reddy YN, Reddy YN (2012) Acute kidney injury in dengue fever using acute kidney injury network criteria: inci-dence and risk factors. Trop Doct. 42(3): 160–162.

Hasan SR, Riaz M, Jafri FA (2013) Char-acteristics and outcome of dengue infection; clinical perspective from a secondary care hospital of Karachi. Pak J Med Sci. 29(1): 115–118.

Banzal S, Ayoola FA, El Sammani FE, Rahim SI, Subramanium P, Gadour MOE, Jain AK (1999) The clinical pattern and complications of severe malaria in the Jazan region of Saudi Arabia. Ann Saudi Med. 1: 378–380.

Ayyub M, Khazindar AM, Lubbad EH, Barlas S, Alfi AY, Al-Ukayli S (2006) Characteristics of dengue fever in a large public hospital, Jeddah, Saudi Arabia. J Ayub Med Coll Abottabad. 18: 9–13.

Gurumurthy R, Gayathri KB, Seethamma

R, Bhargav PRK (2014) Clinical spec¬trum and course of dengue fever during pregnancy: Institutional expe-rience from South India. IOSR-JDMS. 13(3): 93–95.

Khan NA, Azhar EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, Tur¬kistani AM, Hamouh EA (2008) Clin¬ical profile and outcome of hos-pitalized patients during first out-break of dengue in Makkah, Saudi Arabia. Acta Trop. 105(1): 39–44.

Rasheed A, Saeed S, Khan SA (2009) Clinical and laboratory findings in acute malaria cases by various Plasmodium species. J Pak Med As-soc. 54: 220–223.

Gupta NK, Bansal SB, Jain UC, Sahare K (2013) Study of thrombocytopenia in patients of malaria. Trop Parasitol. 3(1): 58–61.

Eapen CE, Eliasi E, Goel A, John TJ (2015) Hypothesis of mechanism of thrombocytopenia in severe dengue, providing clues to better therapy to save lives. Curr Sci. 108(2): 168–169.

Withana M, Rodrigo C, Chang T, Karunanayake P, Rajapakse S (2014) Dengue fever presenting with acute cerebellitis: a case report. BMC Res Notes. 7: 125.

Clémente-Bartoli A, Epelboin L, Daval S, Fabre I, Lamaury I, Beaucaire G (2012) Deep thrombocytopenia due to dengue fever in a patient splenec-tomized for immune thrombocyto-penia. Presse med. 41(11): 1151–1153.

Bashawri LA, Mandil AA, Bahnassy AA, Ahmed MA, Al-Shamsi MA, Bukha-ri HA (2001) Epidemiological pro-file of malaria in a university hospi-tal in eastern region of Saudi Arabia. Saudi Med J. 22: 133–138.

Limaye SL, Londhey VA, Nabar ST (2012) The study of complications of vivax malaria in comparision with falciparum malaria in Mumbai. J Assoc Physicians India. 60: 15–18.

Brattig NW, Kowalsky K, Liu X (2008) Plasmodium falciparum glyco-sylphosphatidylin-ositol toxin inter-acts with the membrane of non-par-asitized red blood cells: a putative mech¬anism contributing to malaria ane¬mia. Microbes Infect. 10: 885–891.

Al-hoot MA, Wang SM, Sekaran SD (2011) Inhibition of dengue virus en-try and multiplication into mono-cytes using RNA interference. PLoS Neg Trop Dis. 5(11): e1410.

Malik GM, Seidi O, El-Taher AM, Mo-hammad AS (1998) Clinical aspect of malaria in the Asir region, Saudi Arabia. Ann Saudi Med. 18: 15–17.

Kochar DK, Kaswan K, Kochar SK, Siro-hi P, Pal M, Kochar A (2006) A comparative study of regression of jaundice in patients of malaria and acute viral hepatitis. J Vect Borne Dis. 43: 123–129.

Ahsan T, Ali H, Bakht SF, Ahmad N, Farooq MU, Shaheer A, Mahmood T (2008) Jaundice and falciparum ma-laria: Changing trends in clinical presen-tation- A need for awareness. J Pak Med Assoc. 58: 616–621.

Abdallah TH, Abeen MT, Ahmad IS, Hamdan ZH, Magzoub M, Adam I (2013) Plasmodium falciparum and Plasmodium vivax malaria among adults at Kassala hospital, Eastern Sudan. Malar J. 12: 148–154.

Phuong HL, de Vries PJ, Nga TTT, Giao PT, Hung LQ, Binh TQ, Nam NV, Nagelkerke N, Kager PA (2006) Den¬gue as a cause of acute undiffer-entiated fever in Veitnam. BMC In-fect Dis. 6: 123.

Premaratna R, Gunatilake AKE, de Silva NR, and Tilakaratne Y, Fonseka MM, de Silva HJ (2001) Severe he-patic dysfunction associated with falciparum malaria. Southeast Asia J Trop Med Pub Health. 32(1): 70–72.

Abro AH, Ustadi AM, Abro HA, Abdau AS, Yunis NJ, Akaila SI (2009) Jaundice with hepatic dysfunction in P. falciparum malaria. J Coll Physi-cians Surg Pak. 19: 363–366.

Uzuegbu UE, Emeka CB (2011) Changes in liver function markers among ma-laria infected patients in Ikeja Lagos State, Nigeria. Curr Res J Biol Sci. 3: 172–174.

Lum LC, Lam SK, George R, Devi S (1993) Fulminant hepatitis in dengue infection. Southeast Asian J Trop Med Public Health. 24(3): 467–471.

Rothman AL, Ennis FA (1999) Immuno-pathogenesis of dengue hemorrhagic fever. Virology. 257: 1–6.

Mannan JA, Ali H, Lal M (2006) Acute renal failure associated with malaria. J Ayub Med Coll Abbottabad. 18(4): 47–52.

Lee IK, Liu JW, Yang KD (2009) Clini-cal characteristics, risk factors, and outcomes in adults experiencing dengue hemorrhagic fever compli-cated with acute renal failure. Am J Trop Med Hyg. 80(4): 651–655.

Khalil MAM, Sarwar S, Chaudry MA, Maqbool B, Khalil Z, Tan J, Yaqub S, Hussain SA (2012) Acute kidney injury in dengue virus infection. Clin Kidney J. 5(5): 390–394.

Lum LC, Lam SK, Choy YS, George R, Harun F (1996) Dengue encephalitis: A true entity? Am J Trop Med Hyg. 54: 256–259.

Giha HA, Elghazali G, A-Elgadir TM, A-Elbasit IE, Eltahir EM, Baraka OZ, Khier MM, Adam I, Troye-Blomberg M, Theander TG, Elbashir MI (2005) Clinical pattern of severe Plasmodium falciparum malaria in Sudan in an area characterized by seasonal and unstable malaria transmission. Trans R, Soc Med Hyg. 99: 243–251.

Thanachartwet V, Desacorn V, Sahas-sananda D, Win KYKK, Supaporn T (2013) Acute renal failure in patients with severe falciparum malaria: Us-ing the WHO 2006 and RIFLE Crite-ria. Int J Nephrol. Article ID 841518, p. 6.

Khan W, Zakai HA, Asma U (2014) Clinico-pathological studies of Plasmodium falciparum and Plas-modium vivax-malaria in India and Saudi Arabia. Acta Parasitol. 59(2): 206–212.

Ngoungou EB, Poudiougou B, Dulac O, Dicko A, Boncoeur MP, Traoré AM, Coulibaly D, Keita MM, Preux PM, Doumbo OK, Druet-Canbanac M (2007) Persistent neurological sequelae due to cerebral malaria in a cohort children from Mali. Rev Neurol. (Paris). 163: 583–588.

Published
2018-06-13
How to Cite
1.
Khan W, Zakai HA, Khan K, Kausar S, Aqeel S. Discriminating Clinical and Biological Features in Malaria and Dengue Patients. jad. 12(2):108-1.
Section
Original Article