A REVIEW ON CO (cid:487) INFECTION WITH DENGUE AND MALARIA

the search included co-infections, dual infections, tropical infections, malaria, and dengue. The search yielded 42 articles; among them, 10 articles were selected using inclusion criteria of articles which addressed co-infection of malaria and dengue. Of the ten selected articles, two were case reports and eight were clinical research studies. The review yielded published studies from 2005 to 2015. Utilizing a review matrix method, [8] a data abstraction form was developed. The selected articles were evaluated, and data were collected into the data abstracting form. Abstracted data elements included reference, title, purpose, design, sample, results, and conclusion for practice. Abstracted data were compared and confirmed by two investigators. Further, the reports were analyzed for the narrative synthesis of each selected articles upon the criteria of internal and external validity, ABSTRACT Introduction: Dengue and Malaria pose a major health concern as separate infections but co-infection with dengue and malaria could pose a new challenge. Both malaria and dengue are vector-borne illnesses being transmitted by mosquitoes, which harbor the infective pathogen. Though co-infection with dengue and malaria are increasingly reported, there is still a lack of clinical suspicion, diagnosis, and treating of concurrent dengue and malaria infection. Purpose: The purpose of this study is to find out the prevalence of dengue and malaria co-infection, associated complications, and impact on clinical severity. Methods: A systematic review was performed using clinical case reports, research articles, and conceptual literature published from 2005 to 2015. These articles were selected for the review with inclusion criteria including clinical case reports and research studies addressing the concepts of concurrent infection with dengue and malaria. The sources of search included PubMed, Medline, and WHO website. Conclusion: The review concluded that existing literature support that concurrent dengue and malaria infection is common and early diagnosis and treatment of which is essential to prevent complications such as jaundice, hepatomegaly, anemia, and thrombocytopenia. A strong clinical suspicion of the diagnosis of concurrent dengue and malaria must arise in febrile patients in areas where both dengue and malaria are both endemic also people traveling to and from the endemic areas. There is also a need for further studies to find out the extent, clinical severity of concurrent infections, and newer and faster diagnostic techniques to detect both the infections. patients with diagnosis of malaria, dengue, and co-infection (vivax malaria ( n = 52), dengue ( n = 30), and co-infection ( n = 30)). The plasma analysis of cytokines and chemokines was performed by multiplex assay. The results indicated that co-infection patients group had lower levels of platelets ( P = 0.0047) and hemoglobin ( P = 0.0001) than malaria patients. In addition, co-infection group had the highest median concentrations of IFN - gamma, IL-6, and CCL4 as compared to mono-infection patients. Network analysis revealed co-infection patients had a distinct immune profile associated with IL-6, CCL4, and IL 10. [17] These study results provide the direction for understanding immunopathology associated with co-infection. However, it is difficult to establish the antecedence of the immune profile associated with co-infection with a descriptive study. Further, as the distinguished pattern of immune profile exists with the diagnosis of co-infection, it will be useful for future studies to focus on the pathophysiological interaction of agent and host of co-infection, which may help in the primary and secondary prevention of the disease. These study results provide level IV evidence for the practice toward the early diagnosis of co-infection among febrile patients. evidence for medicine. It concluded that existing literature support that concurrent dengue and malaria infection is common and early diagnosis and treatment of which is essential to prevent complications such as jaundice, hepatomegaly, anemia, and thrombocytopenia. A strong clinical suspicion of the diagnosis of concurrent dengue and malaria must arise in febrile patients in areas where both dengue and malaria are endemic also people traveling to and from the endemic areas. Examining the immune profile of co-infection is a novel and emerging science. There is also a need for further studies to find out the extent, clinical severity of concurrent infections, and newer and faster diagnostic techniques, including immune profile to detect both the infections.