Abstract
Background: India has the highest malaria incidence in Asia and ranks second globally. Concurrent infections, particularly with dengue and chikungunya are common during monsoon and post monsoon seasons. These co-infections complicate diagnosis and management, especially in resource-limited settings. This study is aimed to investigate the profile, clinical features, and outcomes of co-infections in malaria patients.
Methods: A cross-sectional observational study was conducted in Central India, from June 2023 to October 2024. Patients presenting with acute febrile illness were tested by multiplex polymerase chain reaction for common causes of tropical fever. Clinical and demographic data were collected, and malaria cases with or without co-infections were included. Statistical analysis was performed with significance set at p < 0.05.
Results: Of 587 acute febrile illness patients tested via multiplex PCR, 214 diagnosed malaria cases included. Mono-infections accounted for 63.55%, while 34.45% had concurrent infections (51.28% males, 48.72% females). Co-infections were common with chikungunya (26.92%), dengue (24.36%), rickettsia (14.10%), and scrub typhus (11.54%). Fever lasted <7 days in 92.31% (p < 0.001) cases. Co-infected patients exhibited higher rates of symptoms like maculopapular rash, retro-orbital pain, and bleeding manifestations compared to mono-infected malaria cases. Co-infections showed severe thrombocytopenia, elevated liver markers, and complications like jaundice and abnormal bleeding. Mortality was observed in 07 (03.27%) cases.
Conclusion: This study provides valuable insights into the patterns, prevalence, and clinical implications of malaria co-infections in central India, emphasizing the critical role of advanced diagnostic techniques like multiplex PCR in improving early and accurate diagnosis. The findings underscore the complexity of febrile illnesses in high-burden regions and the necessity for tailored diagnostic and management strategies, particularly during monsoon and post-monsoon seasons. Future research with larger, multicentre studies and long-term follow-up is needed to validate these findings and address existing gaps in knowledge.