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Background  There have been few published reports on severe  Plasmodium falciparum  and  Plasmodium vivax  malaria among adults in Africa.    Methods  Clinical pattern/manifestations of severe  P. falciparum  and  P. vivax  (according to World Health Organization 2000 criteria) were described in adult patients admitted to Kassala Hospital, eastern Sudan.    Results  A total of 139 adult patients (80 males, 57.6%) with a mean (SD) age of 37.2 (1.5) years presented with severe  P. falciparum  (113, 81.3%) or  P. vivax  (26, 18.7%) malaria. Manifestations among the 139 patients included hypotension (38, 27.3%), cerebral malaria (23, 16.5%), repeated convulsions (18, 13.0%), hypoglycaemia (15, 10.8%), hyperparasitaemia (14, 10.1%), jaundice (14, 10.1%), severe anaemia (10, 7.2%), bleeding (six, 4.3%), renal impairment (one, 0.7%) and more than one criteria (27, 19.4%). While the geometric mean of the parasite count was significantly higher in patients with severe  P. vivax  than with severe  P. falciparum  malaria (5,934.2  vs  13,906.6 asexual stage parasitaemia per μL, p = 0.013), the different disease manifestations were not significantly different between patients with  P. falciparum  or  P. vivax  malaria. Three patients (2.2%) died due to severe  P. falciparum  malaria. One had cerebral malaria, the second had renal impairment, jaundice and hypoglycaemia, and the third had repeated convulsions and hypotension.    Conclusions  Severe malaria due to  P. falciparum  and  P. vivax  malaria is an existing entity among adults in eastern Sudan. Patients with severe  P. falciparum  and  P. vivax  develop similar disease manifestations.

Severe Plasmodium falciparum and Plasmodium vivax malaria among adults at Kassala Hospital, eastern Sudan