Giving a new dimension to medical interventions for dengue - both diagnosis and treatment - a study has revealed that a significant chunk of the patients suffering from dengue is also infected with malaria at the same time.
The first of its kind study in the country undertaken at the VSS Medical College and Hospital (VSSMCH), Burla, has established that concurrent malaria infection in dengue patients is prevalent in areas where both the vectors co-exist.
The clinical features in a patient suffering from concurrent infection are predominantly tilted towards dengue, hiding malaria fever. “Thus, there is a necessity to reorient interventions so as to make diagnostic investigations for both dengue and malaria a common practice while dealing with dengue cases,” head of Medicine Department of the VSSMCH, Prof MK Mohapatra, who led the study, said.
The positive findings, however, are that patients suffering from co-infection did not progress to severe malarial stages that could be life threatening. Outcome of concurrent dengue and malaria has been good with patients recovering from both.
Prof Mohapatra said 367 patients suffering from dengue were taken into consideration and concurrent infections were found in 27 accounting for 7.4 per cent. The clinical features were continuous fever, back pain, headache, running nose and bleeding, which were consistent with dengue, making it difficult to diagnose concurrent dengue and malaria.
“Intermittent fever with complications like cerebral malaria, renal failure or multi-organ failure symptomatic of malaria were absent among the patients with concurrent infection. While, bleeding manifestations similar to dengue were common. Therefore, screening for malaria among dengue patients is necessary for diagnosis and prompt treatment”, he stressed.
Plasmodium falciparum infection was found in as high as 88.8 per cent of the cases. But it did not deteriorate in any of the patients.
“Good outcome and absence of severe malaria might be due to the fact that the patients of concurrent infections were treated early. Secondly, low parasitic count was observed among patients of concurrent infections which could be a major contributor for the benign outcome”, Prof Mohapatra added, while emphasising on further studies to determine the manifestations.
The study ‘Manifestation and outcome of concurrent malaria and dengue infection” by MK Mohapatra, P Patra and R Agrawala has been published in the latest issue of Journal of Vector Borne Diseases.