A Comparative Study of Concurrent Dengue and Malaria Infection with their Monoinfection in a Teaching Hospital in Mumbai.

OBJECTIVE This comparative cross sectional study was conducted in a teaching hospital in Mumbai during the monsoon of 2014.A significant number of dengue and malaria co-infection cases, along with dengue, malaria and other infective causes of acute febrile illnesses were noted. The objective of the present study was to understand the interplay of both infections. Since the first such reported case in 2005, studies and data on such cases are scarce, hence this study. AIM To compare the clinical course, laboratory features, severity and outcome of coinfection with monoinfection of malaria and dengue. Malaria sub species too were included in the study. RESULTS In the study period of April-Nov 2014, a comparative cross sectional retrospective study of co-infections of concurrent malaria and dengue (Group A), isolated Dengue (Group B) and isolated Malaria (Group C) was carried out. Out of 156 febrile cases included, 85 (54.48%) were dengue monoinfection, 55 (35.25%) isolated malaria, (P. falciparum- 23 -41.81%, P. vivax 16-29.09% and mixed -16-29.09%) and 16 (10.25%) were co infection cases. The coinfection and dengue groups presented with a similar clinical picture though in the coinfection group, epigastric distress was notable. Among compared laboratory parameters, transaminitis was statistically significant in the co-infection group (p value <0.001). Anaemia was significant in the malaria group whereas the dengue group presented with raised haematocrit. The coinfection group with low haemoglobin and haematocrit, was consistent with concurrent malaria co-infection. Among the severity parameters, bleeding manifestations, renal dysfunction and jaundice, were notable in the coinfection group, compared to the malaria group (12% and 3.6%, 6.3% and 3.6% and 6.3% and 3.6% respectively). Dengue monoinfection group, despite being the largest and with significant incidence of thrombocytopenia (p<0.001), recovered fully. One death was encountered in the coinfection group, with a mortality of 6.3% (1/16) compared to 5.5% (3/55) in the malaria group.