Does Malaria Co-Infection Alter the Clinical Course in Children Infected with Dengue? Analysis from 623 Indian Children Admitted with Dengue Infection.

BACKGROUND

Dengue and malaria co-infection has been reported in several case reports. We aim to study effect of malaria co-infection on clinical outcomes of dengue infection.

METHODS

Records of 623 children with dengue infection, based on NS-1 antigen and IgM ELISA testing, were collected. Malaria co-infection was identified in 20 cases, based on peripheral blood smear examination. Clinical and hematological parameters were compared in two groups (malaria co-infection vs. dengue mono-infection).

RESULTS

Duration of hospitalization was significantly higher in co-infected group. Significantly higher proportion of malaria co-infection cases had hepatosplenomegaly, hemoglobin ≤8 g/dl, serum albumin ≤3 g/dl, serum bilirubin ≥1 mg/dl, serum aspartate aminotransferase ≥500 U/l and serum alanine aminotransferase ≥300 U/l. Number of transfusions (PRBC and platelets) required in malaria co-infection group was higher.

CONCLUSION

Malaria co-infection in dengue impacts clinical presentation, hematological parameters, requirement of blood transfusion and morbidity. High index of suspicion is warranted while evaluating febrile patients.