Hepatic and renal dysfunctions in a malaria endemic region: falciparum malaria vs vivax malaria

Malaria is a major health problem in the tropics. Liver dysfunction has been a common finding in malaria patients. Malaria causes inhibition of certain liver functions without showcasing signs of hepatic insufficiency. After termination of such attack, normal liver may be restored but a continued low-grade malarial infection can cause permanent liver damage. This retrospective study was done in order to study the proportion of hepatic and renal involvement to find possible ways of modifying the clinical outcomes. All malaria positive cases from June 2012 to June 2015 in Kasturba Medical College hospitals were included. The patients were stratified into 3 groups based on the type of malaria Group I – P. vivax, Group II – P.falciparum and Group III- mixed (P.falciparum and P.vivax) and sub-divided based on age and sex. Their hepatic and renal functions were evaluated. Statistical analysis was done using SPSS vers.11.5 using descriptive analysis and ANOVA. A total of 2139 cases of malaria were diagnosed based on their peripheral blood pictures of which males (75%) outnumbered females (25%). In the three groups the proportion of infection was 81.5%, 3.4%, and 15.1% respectively and hepatic dysfunction was 57.3%, 39.2% and 74.7% respectively. Out of the 67 P.falciparum infected patients 70% had renal dysfunction. 61% patients had anaemia. We conclude that malaria is a major health concern in this region, majority being infected with P.vivax. The proportion of patients having severe manifestations like severe anaemia, jaundice, hypoalbuminemia and hepatopathy was more significantly associated with mixed malaria followed by P.vivax.