A study of serum lactate level in malaria and its correlation with severity of disease

• Published in: International Journal of Advanced Medical and Health Research 2015-01, Vol.2 (1), p.28-32
• Main Authors: Dabadghao, Varsha, Singh, Veer, Sharma, Dayal, Meena, Babu
• Format: Article
• Language: English
• Subjects: Analysis; Care and treatment; Complications; hyperlactatemia; India; Malaria; Mortality; Prevalence studies (Epidemiology); Risk factors
• ISSN: 2349-4220; 2350-0298
• DOI: 10.4103/2349-4220.159131

Background: Since there is a high mortality due to malaria, there is a need of a parameter to identify patients at risk of developing complications, whereby intensive care is given to those patients who are at higher risk for complications and mortality. Aims: This study was undertaken to estimate serum lactate levels in patients with Plasmodium vivax, Plasmodium falciparum, and mixed malaria, and also to correlate it with various clinical and biochemical parameters and with the severity and prognosis of malaria. Methods: This was a cross-sectional, analytical, and observational study, which was conducted on 100 patients diagnosed with malaria and older than 14 years of age. Diagnosis of malaria was made by the gold standard method of peripheral blood smear examination and rapid tests. The blood sample for plasma lactate levels on admission was collected from a stasis free vein. The Student′s t-test for continuous normally distributed variables was used. For categorical data, the chi-square test was used and for the small numbers, Fisher′s exact test was used for small numbers. P < 0.05 was considered as a statistical significance at 95% confidence intervals. Results: In this study, there were 90% survivors and 10% of patients succumbed. Out of 90 survivors, 43 patients (47.7%) had some form of complicated malaria, whereas all patients who succumbed (10) had complicated malaria. All the patients who had jaundice, severe thrombocytopenia, renal failure, severe anemia, or hypotension (hypotension was confirmed clinically, but the remainder were confirmed by biochemical parameters such as liver functions, renal functions, platelet count, and hemogram) had hyperlactatemia in this study. All patients who died had a serum lactate level of >2 mmol/l. Conclusions: Hyperlactatemia had significant associations with complications of malaria. Raised serum lactate levels were significantly associated with mortality (P < 0.05).