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Diabetes and Severe Malaria—Clinical Profile and Outcome

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Introduction: Diabetes mellitus is a global burden and India having second largest diabetics in the world. Malaria is a common vector borne disease in developing countries and so also in… Click to show full abstract

Introduction: Diabetes mellitus is a global burden and India having second largest diabetics in the world. Malaria is a common vector borne disease in developing countries and so also in India. Diabetes mellitus may aggravate malaria infection like other infections. Aim: To study the clinical profile and outcome of severe malaria in diabetes mellitus. Methods: This was a descriptive analytical study where 200 adult patients of severe malaria according to WHO criteria admitted to our hospital (SCB Medical College and Hospital, Odisha, India) were studied for clinical profiles, associated comorbid conditions and outcome for a period of two years. We analysed patients with comorbid conditions like diabetes mellitus, hypertension and hypothyroid vs. no comorbid conditions. Only smear positive severe malaria patients were included and detailed clinical examination and laboratory investigations were done in all patients. Patients with other associated conditions like pregnancy, chronic kidney disease and immunocompromised states were excluded. The observed data was statistically analyzed. Result: Out of 200 severe malaria patients 99 were males and 101 were females with mean age of 46.51± SD 3.67 years. Patients with established diabetes mellitus were 54 (male-27, female-27), hypertension were 36 (male-21, female-15), hypothyroid state were 36 (male-10, female-26) and no comorbidities were 74 (male-41, female-33). The mixed malarial infection of both Plasmodium falciparum and Plasmodium vivax was found more in diabetics vs. nondiabetics i.e., 22 (40.74%) vs. 23 (15.75%). There was more multi-organ involvement, shorter coma onset time and longer duration of coma observed on diabetics than nondiabetics. Nineteen (35.18%) patients died amongst 54 diabetics than 20 (13.69%) patients died amongst 146 nondiabetics. Conclusion: There was more death and severity of malaria observed in diabetics than nondiabetics and then other comorbid conditions. Disclosure P.K. Thatoi: None.

Keywords: male female; diabetes mellitus; comorbid conditions; severe malaria; clinical profile; profile outcome

Journal Title: Diabetes
Year Published: 2018

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