A study of serum calcium level in cases of malaria in a tertiary care hospital

Harvy Parikh, Ravi Shah, Nilesh Doctor, Hemant Shah


Background: Malaria is a tropical disease caused by Plasmodium species, commonly P. falciparum and P. vivax. Carpopedal spasm has been noted in many patients presenting with malarial fever. Most of the patients are later found to have hypocalcaemia. Hypocalcaemia associated with malaria can cause many clinical manifestations, including life threatening conditions such as arrhythmias, convulsions etc.

Methods: A cross-sectional study was conducted with the aim to determine the prevalence and clinical profile of hypocalcaemia in different types of malarial fever. 88 patients of malarial fever were studied. Patients were stratified according to the species of plasmodium and into complicated and uncomplicated malaria. Total serum calcium level and QTc interval were analysed in each patient. Data collected were analysed.

Results: Prevalence of hypocalcaemia in malaria was found to be 54.45% in our study. Hypocalcaemia was more prevalent in complicated malaria than uncomplicated malaria. Complicated falciparum malaria showed highest prevalence of hypocalcaemia. Status of complexity of malaria was not found to be related to occurrence of hypocalcaemia in any types of malaria. Prevalence of QTc prolongation in malaria was found to be 48.46%. Prevalence of QTc prolongation was found to be more in complicated malaria than uncomplicated malaria. QTc prolongation was most prevalent in complicated falciparum malaria. 83.3% of those with QTc prolongation had hypocalcaemia.

Conclusions: Hypocalcemia and QTc prolongation were more prevalent in complicated malaria than in uncomplicated malaria. Both Hypocalcaemia and QTc prolongation were most prevalent in complicated falciparum malaria.



Serum calcium, Plasmodium falciparum, Plasmodium vivax

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White NJ, Breman JG. Malaria and other disease caused by red cell parasites. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL et al (editors). Harrisons principles of Internal Medicine, 18th ed New York: McGraw Hill.1998:1180-2.

Davis TM, Pukrittayakamee S, Woodhead JS, Holloway P, Chaivisuth B, White NJ. Calcium and phosphate metabolism in acute falciparum malaria; Clin Sci (Lond). 1991;81(3):297-304.

Petithory JC, Lebeau G, Galeazzi G, Chauty A. Hypocalcemia in malaria. Study of correlations with other parameters;Bull Soc Pathol Exot Filiales. 1983;76(5):455-62.

Ayoola OO, Fawole OI, Omotade OO. Calcium and phosphate levels in Nigerian children with malaria. Ann Trop Paediatr. 2005;25(4):303-6.

Mananje SR, Kabekkodu SP, Sharma A, Saya RP. QT prolongation as an Indicator of Complications in Malaria. mjdrdypu. 2018;11:12-7.

Mohapatra MK, Karua PC, Bariha PK, Panigrahi MK, Patel MR. Parathyroid Dysfunction in Complicated Falciparum Malaria. Journal of Association of Physician of India. 2009;57.

Iwalokun BA, Olukosi YA, Oduro K, Iyamu E. A Study of Calcium Dynamics in Infected Erythrocytes of Nigerian Children with Plasmodium falciparum Malaria. Journal of Medical Sciences. 2007;7:565-71.

Baloch MA, Baloch S, Devrajani BR. Determination of serum calcium in patients with malaria by flame photometer. International Journal of Mosquito Research. 2018;5(3):32-4.

Prabha, Adhikari MR. Clinical Implication of hypocalcemia in malaria ;Journal of Medical Research. 1998;24:71-4.

Mishra S. Malaria-precipitated hypocalcaemia and related complications. The pharma innovation. 2013;2(2):162-9.

Agrawal A, Kahar B, Pandey S. Study of effect of malaria parasitemia on serum electrolytes in southeast Rajasthan. IAIM. 2018;5(5):98-103.

Soni CL, Kumhar Mr, Gupta BK, Singh VB, Srimali L, Nayak KC et al. Prognostic implication of hypocalcemia and QTc interval in malaria; Indian Journal of Medical Research. 2000;37(3-4):61-7.

Rani A, Akhtar S, Nawaz SK, Irfan S, Azam S, Arshad M. Electrolyte disturbance and the type of malarial infection. Iran j public health. 2015;44(11):1492-7.

Davis TM, Li GQ, Guo XB, Spencer JL, St John A. Serum ionized calcium, serum and intracellular phosphate, and serum parathormone concentrations in acute malaria. Trans R Soc Trop Med Hyg. 1993;87(1):49-53.

Zaki SA, Shanbag P. Atypical manifestations of malaria. Dove press journal of Research and Reports in Tropical Medicine. 2011;16-18.