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Journal articles on the topic 'Malaria, complications'
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Soma-Pillay, P., and A. P. Macdonald. "Malaria in pregnancy." Obstetric Medicine 5, no. 1 (January 5, 2012): 2–5. http://dx.doi.org/10.1258/om.2011.110063.
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Malaria is a complex parasitic disease affecting about 32 million pregnancies each year in sub-Saharan Africa. Pregnant women are especially susceptible to malarial infection and have the risk of developing severe disease and birth complications. The target of Millennium Development Goal 6 is to end malaria deaths by 2015. Maternal and perinatal morbidity and mortality due to malaria may be reduced by implementing preventive measures, early diagnosis of suspected cases, effective antimalarial therapy and treatment of complications.
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Vemula, Sachin, Vidyalakshmi Katara, Unnikrishnan Bhaskaran, Sushma Adappa, and Mahabala Chakrapani. "Pretreatment elevated erythrocyte sedimentation rate and C-reactive protein as a predictor of malarial complications." Journal of Infection in Developing Countries 10, no. 12 (December 30, 2016): 1332–37. http://dx.doi.org/10.3855/jidc.8053.
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Introduction: Complications of malaria can develop suddenly and unexpectedly. Although various parameters have been associated with severity of malaria, they have not been studied as predictors of these events. Many of the malarial complications are inflammatory in nature, and C-reactive protein (CRP) and elevated erythrocyte sedimentation rate (ESR) could be early markers of these complications and might precede and predict the development of complications. Methodology: A total of 122 inpatients with uncomplicated newly diagnosed malaria were studied. CRP, ESR, hemoglobin, and platelets were measured before initiating treatment. Patients were monitored closely for the subsequent development of complications based on the World Health Organization’s definition of severe malaria. Results: Seven patients (5.7%) had worsening of symptoms compared to the day of admission and had higher pretreatment CRP and increased ESR compared to those patients who did not develop complications. Area under receiver operator characteristic curve was 0.761(p=0.02) for CRP and 0.739 (p = 0.035) for ESR. CRP>124 mg/L and increased ESR (>34.5 mm in the first hour) had a sensitivity of 71.4% and specificity of 79.1%, respectively, for predicting complications of malaria. Other parameters did not reach statistical significance for predicting complications. Elevated CRP and elevated ESR had a negative predictive value of 97.8%. Conclusions: Elevated CRP>124mg/L and increased ESR>34.5 mm in the first hour at the time of diagnosis in patients with uncomplicated malaria identifies patients who might subsequently develop complications of malaria.
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Stejskal, František. "Neurological complications in malaria." Neurologie pro praxi 20, no. 2 (April 23, 2019): 102–6. http://dx.doi.org/10.36290/neu.2019.023.
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Planche, T., and S. Krishna. "Severe Malaria: Metabolic Complications." Current Molecular Medicine 6, no. 2 (March 1, 2006): 141–53. http://dx.doi.org/10.2174/156652406776055177.
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Leelavathi, V., R. Naveen, and Veeranna Gowda. "Renal Complications in Malaria." Indian Journal of Public Health Research & Development 4, no. 4 (2013): 128. http://dx.doi.org/10.5958/j.0976-5506.4.4.157.
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Patel, Vandana, and Faroque Khan. "Pulmonary Complications of Malaria." Seminars in Respiratory and Critical Care Medicine 12, no. 01 (January 1991): 8–17. http://dx.doi.org/10.1055/s-2007-1006220.
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Scully, Crispian. "Malaria and oral complications." Oral Diseases 14, no. 8 (November 2008): 767. http://dx.doi.org/10.1111/j.1601-0825.2008.01462.x.
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Felix Fiavor and Chukwuma Chinaza Adaobi. "Review on the prevention of malaria among pregnant women attending antenatal clinic." GSC Advanced Research and Reviews 11, no. 3 (June 30, 2022): 135–40. http://dx.doi.org/10.30574/gscarr.2022.11.3.0149.
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The study visualizes the Prevention of Malaria among Pregnant Women Attending Antenatal Clinic. Malaria in pregnancy has been identified as a global health challenge because of the life-threatening complications it poses to both the mother and the unborn child. These complications include maternal anemia, premature delivery, low birth weight, miscarriage, congenital infection and perinatal mortality. Five different malaria parasite species cause malaria infection: Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and Plasmodium knowlesi. The increasing rate of malaria among pregnant women and the lack of adherence to malaria preventive measures have become a matter of great concern for health authorities and midwives. Different factors have been thought of as reasons for the increasing malaria rates. The study review malaria, malaria prevention and control during pregnancy, knowledge of pregnant women on risk factors of malaria, and the attitude of women about the risks of malaria during pregnancy. However, the study recommended that Health training institutions update their curriculum, considering the need for more education on malaria and its prevention policymakers.
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Pradhan, Subal Ku, Pawan Mutalik, Tirumal Subudhi, Arakhita Swain, and Niranjan Mohanty. "Outcomes of paediatric malarial hepatopathy: a study from Eastern India." Paediatrica Indonesiana 54, no. 5 (October 30, 2014): 256. http://dx.doi.org/10.14238/pi54.5.2014.256-9.
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Background Severe malaria causes multi-organ involvement ,including hepatic dysfunction.Jaundice in severe malaria is foundmore commonly in adults than in children. It is important toassess the factors associated with malarial hepatopathy, the variedclinical presentations, as well as the complications in order toinitiate early interventional measures. There are a limited numberof studies in the pediatric population on malarial hepatopathy.Objective To assess the factors associated with malarialhepatopathy, the varied clinical presentations, as well as itscomplications.Methods This prospective study was conducted in the Departmentof Paediatrics, Sardar Vallabh Bhai Patel Post Graduate Institute ofPaediatrics (SVPPGIP), Cuttack, Odisha, India from January 20 10to June 2013, and included 70 children with malaria and jaundice,aged 6 months to 14 years. Malaria was confirmed by microscopicexamination of blood smears. Detailed clinical evaluations andinvestigation s were carried out to find multi-organ afflictions,with a special emphasis on hepatic involvement.Results Of218 children with malaria admitted during this period,70 (32%) children had fever and jaundice on presentation. Allchildren who had both Plasmodium faldparum and vivax infectionhad malarial hepatopathy. Complications, including acutekidney injury (AKI), disseminated intravascular coagulation(DIC), cerebral malaria, and mortality, were significantlyhigher among children with malarial hepatopathy compared tochildren without hepatopathy. Howevei; there was no significantdifference of hypoglycemia, respiratory distress syndrome (RDS),convulsions or severe anemia, between children with and withouthepatopathy.Conclusion Hepatopathy is more common with mixed malariainfections. The incidence of AKI, DIC, cerebral malaria, andmortality are significantly higher in patients with hepatopathy.Malarial hepatopathy should be considered in patients presentingwith acute febrile illness and jaundice so that specific treatmentcan be initiated early to prevent increased morbidity and mortality.
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Punnath, Kishore, Kiran K. Dayanand, Valleesha N. Chandrashekar, Rajeshwara N. Achur, Srinivas B. Kakkilaya, Susanta K. Ghosh, Suchetha N. Kumari, and D. Channe Gowda. "Association between Inflammatory Cytokine Levels and Thrombocytopenia during Plasmodium falciparum and P. vivax Infections in South-Western Coastal Region of India." Malaria Research and Treatment 2019 (April 11, 2019): 1–10. http://dx.doi.org/10.1155/2019/4296523.
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Background. Thrombocytopenia is a most commonly observed complication during malaria infections. Inflammatory cytokines such as IL-1, IL-6, and IL-10 have been documented in malaria induced thrombocytopaenia. This study was aimed to understand the possible relationship between inflammatory cytokines across varying degrees of thrombocytopenia during P. vivax, P. falciparum, and mixed infections. Methods. A hospital-based cross sectional study was conducted at District Wenlock Hospital in Mangaluru, a city situated along the south-western coastal region of Arabian Sea in India. In this study, blood samples from 627 malaria patients were analyzed for infected parasite species, clinical conditions, platelet levels, and key cytokines that are produced in response to infection; samples from 176 uninfected healthy individuals were used as controls. Results. The results of our study showed a high prevalence of malarial thrombocytopenia (platelets <150 ×103/μl) in this endemic settings. About 62.7% patients had mild-to-moderate levels of thrombocytopenia and 16% patients had severe thrombocytopenia (platelets <50 × 103/μl). Upon comparison of cytokines across varying degrees of thrombocytopenia, irrespective of infecting species, the levels of TNF-α and IL-10 were significantly higher during thrombocytopenia, whereas IL-6 levels were considerably lower in severe thrombocytopenia patients suffering from P. vivax or P. falciparum infections. The severe clinical complications observed in patients with malarial thrombocytopenia included severe anemia (17.5%), acute renal failure (12.7%), jaundice (27.0%), metabolic acidosis (36.5%), spontaneous bleeding (3.2%), hypoglycemia (25.4%), hyperparasitemia (4.8%), acute respiratory distress syndrome (1.6%), pulmonary edema (19.0%), and cerebral malaria (1.6%) in various combinations. Conclusion. Overall, the results of our study suggest that inflammatory cytokines influence the transformation of mild forms of thrombocytopenia into severe forms during malarial infections. Further studies are needed to understand the association of inflammatory cytokine responses with severe malaria complications and thrombocytopenia.
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Kamminana, Geetha Priyadarsini, Jyotirmayi Boddu, and Vasudev Rajapantula. "A Study of Clinical Profile and Outcome in Adults with Plasmodium vivax Malaria." Journal of Evidence Based Medicine and Healthcare 7, no. 43 (October 26, 2020): 2470–73. http://dx.doi.org/10.18410/jebmh/2020/511.
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BACKGROUND Among malarial parasites, Plasmodium vivax is most prevalent in humans. Recent studies have shown severe and fatal complications with Plasmodium vivax infection. We wanted to evaluate the clinical spectrum, complications and outcomes of adult subjects with Plasmodium vivax malaria mono-infection. METHODS This is a retrospective study involving 100 subjects RESULTS Males were more commonly affected. It was most prevalent in the second decade of life. Fever was present in all patients. The other common symptoms were headache, vomiting, and jaundice. The incidence of associated clinical findings were pallor (43 %), icterus (21%), hepatomegaly (39 %) and splenomegaly (27 %). Severe thrombocytopenia was seen in 18 %, hyper bilirubinaemia in 39 % of subjects. Cerebral malaria was observed in 3 %, acute kidney injury in 13 %, ARDS (Acute Respiratory Distress Syndrome) in 5 % cases, MODS (Multi Organ Dysfunction Syndrome) was seen in 3 % cases, with a mortality of 3 %. CONCLUSIONS Complications like ARDS, AKI (Acute Kidney Injury), cerebral malaria and MODS were observed in benign tertian malaria subjects in our study. Cerebral malaria, AKI, MODS, ARDS were associated with high degrees of mortality. KEYWORDS Plasmodium vivax, ARDS (Acute Respiratory Distress Syndrome), Cerebral Malaria, AKI (Acute Kidney Injury), MODS (Multiorgan Dysfunction Syndrome)
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Waris, Rehmana, Brekhna Aurengzeb, Syed Hashim Raza, Aimen Waris, and Ramish Riaz. "Clinical Profile and Spectrum of Complications of Malaria in Hospitalized Children at a Tertiary Care Hospital." Journal of Rawalpindi Medical College 25, no. 4 (December 31, 2021): 516–20. http://dx.doi.org/10.37939/jrmc.v25i4.1752.
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Background: In children, clinical profile of malaria may vary from nearly asymptomatic disease to febrile illness leading to life threatening complications. The mortality among children is largely due to complications like cerebral malaria, severe anemia and pulmonary complications. The current study was conducted to study the clinical profile of malaria, its complications and factor associated with its complications.
Methodology: This observational study was conducted at Children Hospital, PIMS from March 2018 to March 2021. All patients with positive immunochromatographic test and needing hospitalization due to unsettled fever or other troublesome symptom were included. Total 53 patients were included in the study. All patients underwent routine investigations which included ICTMP, complete blood picture, ultrasound abdomen, chest x rays, and routine urinary analysis. Severe malaria was characterized upon WHO guidelines. Patients were treated with chloroquine while those resistant to chloroquine were given artemisinin-based therapy. Data was analyzed by applying appropriate statistical tests via SPSS v 20.
Results: Mean age of the patients was 5.80±3.5 years with male predominance (n=32, 60.4%). Majority of the patients had P.vivax (n=45, 84.9%) infection followed by P.falciparum (n=5, 9.4%), while 3 patients (5.7%) had positive immunochromatographic test for both P.vivax and P.falciparum. Severe malaria developed in 17 (32.1%) of the patients. Most common complication was severe anemia (n=10, 18.8%) followed by black water fever, ADEM disease, pneumonia and convulsions Patients with P.falciparum infection had higher risk (OR=8.00, P-value=0.07) of developing complication compared to P.vivax one.
Conclusion: Rate of severe malaria was found to be 32.1% in children of current study which is quite high. Therefore, every child with malaria should be properly investigated for complications and treated accordingly.
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Alao, Adekola O., and Mantosh J. Dewan. "Psychiatric Complications of Malaria: A Case Report." International Journal of Psychiatry in Medicine 31, no. 2 (June 2001): 217–23. http://dx.doi.org/10.2190/cxvf-3xq7-c0ay-7fm4.
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This article reviews the psychiatric complications of malaria. A case of malaria infection is described. The diagnoses, treatment, and neuropsychiatric complications of acute and chronic malaria infection are discussed. The treatment of malaria and its complications are summarized.
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Kulkarni, Vrinda K., and Kushal Agrawal. "A study of clinical profile of malaria with special reference to complications and outcome." International Journal of Advances in Medicine 4, no. 2 (March 23, 2017): 317. http://dx.doi.org/10.18203/2349-3933.ijam20171010.
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Background: Malaria has a wide clinical spectrum ranging from uncomplicated disease to a fatal one. The objectives were to study clinical profile of Malaria with special reference to its complications and outcome.Methods: A prospective observational study was done in a tertiary care hospital including total of 300 patients diagnosed with Vivax or Falciparum Malaria. Data on patients’ clinical details with investigations, complications, and outcome was recorded and analysed using SPSS version 17.Results: Out of 300 patients, 179 had Vivax and 121 had Falciparum Malaria. Oliguria, high coloured urine, altered sensorium, convulsion, breathlessness, bleeding was more common in Falciparum malaria. Hypoglycaemia, thrombocytopenia, renal and hepatic involvement and ALI/ARDS were also more common in falciparum group. However, ALI/ARDS was more fatal in vivax group. Complications, outcome and biochemical parameters were correlated with parasite index and the correlations were statistically significant. Out of 22 deaths, 12 patients were from falciparum and 10 were from vivax group. Most common complication leading to death was ARDS/ALI, followed by AKI, convulsion, hepatic involvement and bleeding in decreasing order in both types of Malaria. Three patients with parasitic index <5% and 19 patients with parasitic index >5% died.Conclusions: Clinical profile of Falciparum Malaria was more complicated. Metabolic complications with multi organ involvement, ALI/ARDS and mortality were more in Falciparum Malaria. Correlation of parasitic index with complications, biochemical parameters and outcome in both the groups was statistically significant.
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Nwosu, SNN. "Ocular complications of malaria treatment." Nigerian Journal of Clinical Practice 15, no. 1 (2012): 95. http://dx.doi.org/10.4103/1119-3077.94108.
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Ozsoy, M. F., O. Oncul, Z. Pekkafali, A. Pahsa, and O. S. Yenen. "Splenic complications in malaria: report of two cases from Turkey." Journal of Medical Microbiology 53, no. 12 (December 1, 2004): 1255–58. http://dx.doi.org/10.1099/jmm.0.05428-0.
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Malaria is still a major health problem in Turkey, where Plasmodium vivax malaria is endemic. Spontaneous rupture of the spleen is an important and life-threatening complication and occurs in up to an estimated 2 % of cases. Hence the small number of case reports suggests under-reporting or underdiagnosis. Review articles have reported only 18 malaria cases with spontaneous splenic rupture in the English language literature since 1960. Two cases of P. vivax malaria with splenic complications are reported here. One of them showed signs and symptoms of acute abdominal pain, then splenic rupture occurred.
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Sangowawa, Adesola O., Olukemi K. Amodu, Subulade A. Olaniyan, Folakemi A. Amodu, Peter E. Olumese, and Olayemi O. Omotade. "Factors Associated with a Poor Treatment Outcome among Children Treated for Malaria in Ibadan, Southwest Nigeria." Epidemiology Research International 2014 (February 26, 2014): 1–7. http://dx.doi.org/10.1155/2014/974693.
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We present data on factors associated with poor treatment outcome (death or recovery with a neurological complication) among children treated for malaria in Ibadan, Nigeria. A total of 2468 children (1532 with uncomplicated and 936 with severe malaria) were recruited from three government facilities. History was obtained from caregivers and malarial parasite test was carried out on each child. About 76.0% of caregivers had instituted home treatment. Following treatment, 2207 (89.5%) children recovered without complications, 9.1% recovered with neurological complications, and 1.4% died. The possibility of poor treatment outcome increased with decreasing child’s age (P<0.0001). A statistically significant proportion of children with pallor, jaundice, hepatomegaly, splenomegaly, respiratory distress, and severe anaemia had poor treatment outcome. Following logistic regression, child’s age < 12 months compared to older age groups (O.R = 5.99, 95% C.I = 1.15–31.15, and P=0.033) and loss of consciousness (O.R = 4.55, 95% CI = 1.72–12.08, and P=0.002) was significantly associated with poor treatment outcome. We recommend interventions to improve caregivers’ awareness on the importance of seeking medical care early. This will enhance early diagnosis and treatment and reduce the likelihood of complications that lead to poor treatment outcomes.
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Babokh, Fatima, Soumia Nachat, Ibtissam Ait Boucetta, Youssra El Amrani, Fatimzahra Rahali, and Awatif El Hakkouni. "MIXED MALARIA INFECTION: ABOUT AN IMPORTED CASE AND REVIEW OF THE LITERATURE." International Journal of Advanced Research 10, no. 04 (April 30, 2022): 481–85. http://dx.doi.org/10.21474/ijar01/14571.
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Mixed malaria infections with Plasmodium are rare and can lead to more serious complications than a single infection. They are particularly common in travelers to malaria-endemic areas. Proper diagnosis and treatment of cases help to control this infection.We report the case of a rare and severe malaria infection, associating two plasmodial species: Plasmodium falciparum and P.vivax, with high parasitemia and fatal complication.
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Holm, Anna Engell, Laura C. Gomes, Claudio Romero Farias Marinho, Odilson M. Silvestre, Lasse S. Vestergaard, Tor Biering-Sørensen, and Philip Brainin. "Prevalence of Cardiovascular Complications in Malaria: A Systematic Review and Meta-Analysis." American Journal of Tropical Medicine and Hygiene 104, no. 5 (May 5, 2021): 1643–50. http://dx.doi.org/10.4269/ajtmh.20-1414.
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ABSTRACTRecent studies have suggested that malaria may affect the cardiovascular system. The aim of this systematic review and meta-analysis was to determine the prevalence of cardiovascular complications in symptomatic malaria patients. We searched databases such as Pubmed, Embase, Cochrane, and Web of Science (January 1950–April 2020) for studies reporting on cardiovascular complications in adults and children with malaria. Cardiovascular complications were defined as abnormalities in electrocardiogram (ECG), cardiac biomarkers, and echocardiography on admission or during outpatient examination. Studies of patients with known heart disease or cardiovascular evaluation performed after the start of intravenous antimalarial medication were excluded. The study was registered in International Prospective Register of Systematic Reviews (PROSPERO) (No.: CRD42020167672). The literature search yielded 1,243 studies, and a total of 43 studies with symptomatic malaria patients were included. Clinical studies (n = 12 adults; n = 5 children) comprised 3,117 patients, of which a majority had Plasmodium falciparum (n = 15) and were diagnosed with severe malaria (n = 13). In random-effects models of adults, the pooled prevalence estimate for any cardiovascular complication was 7% (95% CI: 5–9). No meta-analysis was conducted in children, but the range of abnormal ECG was 0–8%, cardiac biomarkers 0–57%, and echocardiography 4–9%. We analyzed 33 cases (n = 10 postmortem), in which the most common cardiovascular pathologies were myocarditis and acute coronary syndrome. All histopathological studies found evidence of parasitized red blood cells in the myocardium. Cardiovascular complications are not uncommon in symptomatic adults and children with malaria. Additional studies investigating malaria and cardiovascular disease are encouraged.
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A S, Dr Chouhan. "To Study Clinical Profile and Complications of Plasmodium Vivax Malaria." Journal of Medical Science And clinical Research 05, no. 06 (June 16, 2017): 23487–91. http://dx.doi.org/10.18535/jmscr/v5i6.113.
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Irmanita, Rachmadania, Sri Suryani Prasetiyowati, and Yuliant Sibaroni. "Classification of Malaria Complication Using CART (Classification and Regression Tree) and Naïve Bayes." Jurnal RESTI (Rekayasa Sistem dan Teknologi Informasi) 5, no. 1 (February 13, 2021): 10–16. http://dx.doi.org/10.29207/resti.v5i1.2770.
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Malaria is a disease caused by the Plasmodium parasite that transmitted by female Anopheles mosquitoes. Malaria can become a dangerous disease if late have the medical treatment. The late medical treatment happened because of misdiagnosis and lack of medical staff, especially in the countryside. This problem can cause severe malaria that has complications. This study creates a system prediction to classify the severe malaria disease using Classification and Regression Tree (CART) method and the probability of malaria complication using Naïve Bayes method. The first step of this study is classifying the patients that have symptom are infected severe malaria or not based on the model that has been built. The next step, if the patient classified severe malaria then the data predicted if there any probability of complication by the malaria. There are 8 possibilities of complication malaria which are convulsion, hypoglycemia, hyperpyrexia, and the combinations of these four. The first step will evaluate by using F-score, precision and recall while the second step will evaluate by using accuracy. The highest result F-score, precision and recall are 0.551, 0.471 and 0.717. The highest accuracy 81.2% which predicted the complication is Hypoglycemia.
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Cabezón Estévanez, Itxasne, and Miguel Górgolas Hernández-Mora. "Pulmonary complications of malaria: An update." Medicina Clínica (English Edition) 146, no. 8 (April 2016): 354–58. http://dx.doi.org/10.1016/j.medcle.2016.06.017.
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Zubairi, Ali, Anita Fazal, Afsheen Raza, Javed Husain, and Asim Beg. "Pulmonary Complications of Plasmodium Vivax Malaria." Chest 142, no. 4 (October 2012): 194A. http://dx.doi.org/10.1378/chest.1386712.
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Palem, Gowthami, and Sharan J. Pal. "Maternal and fetal outcome of malaria in pregnancy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 10 (September 26, 2019): 4040. http://dx.doi.org/10.18203/2320-1770.ijrcog20194377.
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Background: Malaria, an oldest recorded parasitic infection transmitted by mosquitoes, is one of the most devastating infectious diseases. Mangalore, government headquarters of Dakshin Kannada district in Karnataka, receives high rainfall and exhibits humid tropical environment, harboring high vector density and contributing to high incidences of malaria. The aim of the present study was to observe maternal and fetal outcome of malaria in pregnancy.Methods: This is an observational prospective study conducted from September 2014 to September 2015 at Lady Goschen Hospital, Mangalore which serves as tertiary level hospital. Study population included were pregnant women diagnosed to have malaria by rapid diagnostic test or microscopy as an outpatient or inpatient during the study period. Complications were noted in terms of maternal and foetal complications.Results: A total of 12600 pregnant women attended LGH during study period out of which 41 were positive for malaria which has a prevalence of 0.32%. Among the malaria cases, 23 cases were primigravidae and 18 were multi-gravidae. The commonest pathogen found was Plasmodium vivax accounting for 63.4%. Regarding complications maternal anaemia and thrombocytopenia accounted for 34.1% and 26.8% respectively. Pregnancy outcomes were 17% of spontaneous miscarriage, 21.8% preterm deliveries, 29.1% low birth weight babies and 2.4% perinatal deaths.Conclusions: Malaria adversely affects both pregnant female as well as fetus. It is therefore advised all patients with fever in pregnancy must have screening for malarial parasite and treated adequately by medicine and supportive care to improve the maternal and fetal outcome.
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McDevitt, Michael A., Jianlin Xie, Shanmugasundaram Ganapathy-Kanniappan, Jason Griffith, Aihua Liu, Courtney McDonald, Philip Thuma, et al. "A critical role for the host mediator macrophage migration inhibitory factor in the pathogenesis of malarial anemia." Journal of Experimental Medicine 203, no. 5 (April 24, 2006): 1185–96. http://dx.doi.org/10.1084/jem.20052398.
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The pathogenesis of malarial anemia is multifactorial, and the mechanisms responsible for its high mortality are poorly understood. Studies indicate that host mediators produced during malaria infection may suppress erythroid progenitor development (Miller, K.L., J.C. Schooley, K.L. Smith, B. Kullgren, L.J. Mahlmann, and P.H. Silverman. 1989. Exp. Hematol. 17:379–385; Yap, G.S., and M.M. Stevenson. 1991. Ann. NY Acad. Sci. 628:279–281). We describe an intrinsic role for macrophage migration inhibitory factor (MIF) in the development of the anemic complications and bone marrow suppression that are associated with malaria infection. At concentrations found in the circulation of malaria-infected patients, MIF suppressed erythropoietin-dependent erythroid colony formation. MIF synergized with tumor necrosis factor and γ interferon, which are known antagonists of hematopoiesis, even when these cytokines were present in subinhibitory concentrations. MIF inhibited erythroid differentiation and hemoglobin production, and it antagonized the pattern of mitogen-activated protein kinase phosphorylation that normally occurs during erythroid progenitor differentiation. Infection of MIF knockout mice with Plasmodium chabaudi resulted in less severe anemia, improved erythroid progenitor development, and increased survival compared with wild-type controls. We also found that human mononuclear cells carrying highly expressed MIF alleles produced more MIF when stimulated with the malarial product hemozoin compared with cells carrying low expression MIF alleles. These data suggest that polymorphisms at the MIF locus may influence the levels of MIF produced in the innate response to malaria infection and the likelihood of anemic complications.
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Abdelwahab, Salih, Abdelsalam MA Nail, and GadAllah Osman Modawe. "The Association between CRP Levels with Comorbidities, Species, and Complications of Severe Malaria." AL-Kindy College Medical Journal 18, no. 3 (December 31, 2022): 207–12. http://dx.doi.org/10.47723/kcmj.v18i3.867.
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Background: Malaria remains a leading cause of mortality in sub-Saharan Africa (including Sudan). C-reactive protein (CRP) is useful as a marker of severity in malaria. African studies have shown that serum CRP levels correlate with parasite burden and complications in malaria, especially falciparum. However, there are no data on CRP levels in Sudanese malaria patients. This study aims to evaluate the association between CRP levels with comorbidities, species, and complications of severe malaria Subjects and Methods: A cross-sectional study enrolled 65 severe malaria patients at Khartoum state hospitals during the period from April to June2021. Manifestations of severe malaria were defined according to WHO criteria. Data regarding demographics, presenting symptoms & signs, laboratory investigations, complications, length of hospital stay and outcomes were collected. CRP was classified as elevated when the measured level was >10 mg/l. Results: Among 65 patients, 33(50.8%) were females and 32(49.2%) were males, and mean age was 48±21 years. The main manifestation of severe malaria diagnosis criteria was anemia in 26(40%) patients. Most of the patients had density 1+ (n=53; 81.5%) and were infected by P. falciparum (n=61; 93.8%). The overall case fatality rate for malaria was 8% (n=15 patients). The mean of CRP was 72±57 mg/L and 84% (n=55) of patients had elevated levels above 10 mg/L (ranged from 10-100 mg/L in 52%, and above 100 mg/L in 32%). The elevated CRP levels were significantly DM (P= 0.048), high malaria parasite density in blood film (P= 0.001), P. falciparum (P= 0.33), presence of complications (P= 0.001) and death (P= 0.003) Conclusion: Elevated CRP levels were found in a considerable proportion of severe malaria patients. CRP is an effective biomarker in assessing malaria severity and poor prognosis in term of complications development and mortality.
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Zeb, Jehan, Mian Sayed Khan, Naseer Ullah, Hamid Ullah, Musharaf Khan, Ghulam Nabi, and Abid Ali. "Evaluation of Plasmodium Infestation and Malarial Complications among Pre-School Going Children in District Lower Dir, Pakistan." Journal of Biology and Life Science 6, no. 2 (April 3, 2015): 81. http://dx.doi.org/10.5296/jbls.v6i2.7174.
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The purpose of this study was to show Plasmodium species burden and symptoms consistent with malaria related complications among pre-school going children in North Western part of Pakistan (Timergara, Munda, Maidan, Samar Bagh and Talash). A total of 1312 blood samples were collected during winter, autumn and summer (2011), from males (808, 61.5%) and females (504, 38.4%). Microscopy and rapid diagnostic tests (RDT) were used for the detection of plasmodium species. Questionnaires were also designed to collect information about the health conditions of malarial symptomatic children. Overall data revealed that 6.9% samples were infected, with Plasmodium vivax (96.7%), Plasmodium falciparum (2.1%) and mixed species (P. vivax and P. falciparum) (1.0%). Highest infection rate was recorded in autumn (2.87%) followed by summer (2.45%) and winter (1.73%). Among malaria symptomatic children symptoms like severe temperature (9.85%) lower RBS count (3.7%), Glucose 6-phosphate dehydrogenase (G-6PD) deficiency (0.65%), respiratory distress (0.65%), neonatal sepsis (0.64%) and low birth weight (0.42%) were observed. Shortly malaria control efforts should be taken with an emphasis on improving species diagnosis and treatment availability in district Dir Lower.
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Lopansri, Bert K., Nicholas M. Anstey, Gregory J. Stoddard, Esther D. Mwaikambo, Craig S. Boutlis, Emiliana Tjitra, Helena Maniboey, et al. "Elevated Plasma Phenylalanine in Severe Malaria and Implications for Pathophysiology of Neurological Complications." Infection and Immunity 74, no. 6 (June 2006): 3355–59. http://dx.doi.org/10.1128/iai.02106-05.
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ABSTRACT Cerebral malaria is associated with decreased production of nitric oxide and decreased levels of its precursor, l-arginine. Abnormal amino acid metabolism may thus be an important factor in malaria pathogenesis. We sought to determine if other amino acid abnormalities are associated with disease severity in falciparum malaria. Subjects were enrolled in Dar es Salaam, Tanzania (children) (n = 126), and Papua, Indonesia (adults) (n = 156), in two separate studies. Plasma samples were collected from subjects with WHO-defined cerebral malaria (children), all forms of severe malaria (adults), and uncomplicated malaria (children and adults). Healthy children and adults without fever or illness served as controls. Plasma amino acids were measured using reverse-phase high-performance liquid chromatography with fluorescence detection. Several plasma amino acids were significantly lower in the clinical malaria groups than in healthy controls. Despite the differences, phenylalanine was the only amino acid with mean levels outside the normal range (40 to 84 μM) and was markedly elevated in children with cerebral malaria (median [95% confidence interval], 163 [134 to 193] μM; P < 0.0001) and adults with all forms of severe malaria (median [95% confidence interval], 129 [111 to 155] μM; P < 0.0001). In adults who survived severe malaria, phenylalanine levels returned to normal, with clinical improvement (P = 0.0002). Maintenance of plasma phenylalanine homeostasis is disrupted in severe malaria, leading to significant hyperphenylalaninemia. This is likely a result of an acquired abnormality in the function of the liver enzyme phenylalanine hydroxylase. Determination of the mechanism of this abnormality may contribute to the understanding of neurological complications in malaria.
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Singh, S., Ragini Singh, and Niaz Ahmad. "Complications of vivax malaria in Uttarakhand, India." International Journal of Research in Medical Sciences 1, no. 4 (2013): 532. http://dx.doi.org/10.5455/2320-6012.ijrms20131139.
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Nagarwal, Amitesh, and P. D. Meena. "Incidence of complications in patients of Plasmodium vivax malaria at a tertiary center in Northwest India." International Journal of Advances in Medicine 6, no. 4 (July 24, 2019): 1110. http://dx.doi.org/10.18203/2349-3933.ijam20193255.
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Background: Malaria is a protozoal disease caused by infection with parasites of Plasmodium species, such as P. vivax, P. falciparum, P. malariae, P. ovale and P. knowlesi through female Anopheles mosquito. Plasmodium vivax alone causes 60 to 65% of infections in India. The main objective of the study was to observe various complications in the patients affected with P. vivax malaria and to analyse the clinical, hematological and biochemical profile of these patients.Methods: A non-randomized prospective study was carried out on 170 patients with acute febrile illness admitted in the department of Medicine, SMS Hospital, Jaipur during period from October 2011 to September 2012 presented The infection was confirmed by detection of parasite (for P. vivax) in peripheral blood film by thick and thin slide methods and rapid diagnostic test (Optimal test).Results: Male preponderance was seen in the study. Death was noted in 5 (3%) patients. Thrombocytopenia (85%) was the most common finding observed. Level of serum creatinine was more than 1.5 mg/dl in 34.7% patients. Thirty-one patients (18.23%) had severe anaemia (Hb <6 gm/dl). Severe hypoglycemia was observed in 19 patients (<40-60 mg/dl). Acute renal failure was common comorbidity observed in majority of the patients. Mean LDH value was significantly higher in patients with hepatitis and anemia.Conclusions: The clinical pattern of P. vivax monoinfection has changed recently. Every patient of P. vivax malaria should be evaluated thoroughly for clinical or biochemical evidence of any complications and patients presenting with complications should managed as per guidelines of severe malaria.
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Kaur, Prabhjot, Arun Bhatia, Kanav Midha, and Mampi Debnath. "Malaria: A Cause of Anemia and Its Effect on Pregnancy." World Journal of Anemia 1, no. 2 (2017): 51–62. http://dx.doi.org/10.5005/jp-journals-10065-0012.
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ABSTRACT Malaria is one of the major health problems in the world. It remains an important cause of very high human morbidity and mortality, especially, among children and pregnant women. It results from the infection of parasites belonging to the genus Plasmodium. Plasmodium falciparum and Plasmodium vivax are the major pathogens responsible for causing human malaria. Approximately 75% of cases are caused by P. falciparum and associated with the mortality rate of approximately 0.5 to 1.0%. Both P. falciparum and P. vivax induce anemia during their erythrocytic stages of infection. Most of the malarial infections are related to some degree of anemia, the severity of which depends upon patient-specific characteristics (e.g., age, innate and acquired resistance, comorbid features, etc.) as well as parasite-specific characteristics (e.g., species, adhesive, and drug-resistant phenotype, etc.). Malarial anemia encompasses reduced production of erythrocytes as well as increased removal of circulating erythrocytes in the bone marrow. Susceptibility to severe malarial anemia is associated with the polymorphisms of the cytokines, which are likely to function by perturbing erythropoiesis. This article reviews the epidemiology, pathophysiology, clinical features, treatment, and various complications occurring due to malarial anemia. The second part of this article also focuses on the effect of malaria during pregnancy. Some significant effects of malaria during pregnancy include spontaneous abortion, preterm delivery, low birthweight, stillbirth, congenital infection, and maternal death. How to cite this article Saxena R, Bhatia A, Midha K, Debnath M, Kaur P. Malaria: A Cause of Anemia and Its Effect on Pregnancy. World J Anemia. 2017;1(2):51-62.
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N., Raghu Murthy, and Seema Rai. "Analysis of clinical profile and prescription pattern of malaria in a tertiary care hospital in Karnataka, India." International Journal of Basic & Clinical Pharmacology 8, no. 8 (July 23, 2019): 1744. http://dx.doi.org/10.18203/2319-2003.ijbcp20193136.
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Background: Malaria is one of the leading causes of morbidity and mortality in developing countries like India. Plasmodium falciparum and Plasmodium vivax are the commonest species implicated for an increased incidence of malaria in India. The pattern of disease, signs, and symptoms vary from place to place, region to region due to demographic variations. The current study was undertaken to study the differences in the clinical profile of malaria, particularly signs and symptoms, complications and response to treatment in malaria.Methods: A retrospective, single center, surveillance study was carried out at a tertiary health care center in Mangalore. All patients aged above 18 years diagnosed as malaria by peripheral smear method and rapid diagnostic tests were included in the study. The clinical features, complications, and response to treatment were noted.Results: Fifty eight patients diagnosed as malaria were included in the study. Compared to other studies and nationwide incidences, here P. vivax emerged as the leading cause of malaria. All patients presented with fever varying from 3-20 days. About 30 patients complained of headache and 21 patients presented with malaise. In about 6 patient’s complications were seen. Majority of patients received artemisinin derivatives followed by chloroquine for treatment of malariaConclusions: Previous thinking that complications are only seen with P. falciparum has to be changed. Now many complications, mild as well as severe type are seen in P. vivax malaria. Drug resistance is another global problem which needs to be tackled wisely by systematic usage of antimalarials.
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Warrell, D. A. "Pathophysiology of severe falciparum malaria in man." Parasitology 94, S1 (January 1987): S53—S76. http://dx.doi.org/10.1017/s0031182000085826.
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The term severe falciparum malaria implies an infection with manifestations and complications which are potentially fatal in man, the natural host for this parasite. Much that has been written on the pathophysiology of animal malarias is of doubtful relevance to the understanding of the mechanism ofPlasmodium falciparuminfection in man. The clinical picture of severeP. falciparuminfection differs in several respects from severe animal malarias, even those of non-human primates. Cerebral dysfunction is the most common severe manifestation of falciparum malaria in man. Coma develops suddenly after a generalized convulsion or gradually towards the end of the first week of illness. There are signs of a symmetrical upper motor neurone lesion and brain-stem dysfunction, but only about 5% of survivors show persisting neurological deficit after 2 or 3 days of unconsciousness. The mortality of cerebral malaria depends on how it is defined and on the predominant age group and other factors. In patients with proved acuteP. falciparuminfection with unrousable coma, in whom other causes of encephalopathy have been excluded, the mortality is between 15 and 50% despite treatment with antimalarial drugs (Warrell, Looareesuwan, Warrell, Kasemsarn, Intaraprasert, Bunnag & Harinasuta, 1982).
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Dev, Nishanth, Jhuma Sankar, and B. Lall. "Evaluation of complications and factors associated with multi-organ dysfunction in malaria: a cross sectional study." International Journal of Advances in Medicine 5, no. 4 (July 23, 2018): 954. http://dx.doi.org/10.18203/2349-3933.ijam20183127.
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Background: Prevalence of complications in malaria continues to grow even with reducing number of malaria cases. Complications associated with malaria can involve multiple organs. There is paucity of literature on factors associated with multi organ dysfunction in different types of malaria.Methods: Our aim was to study the clinical profile of complications in different types of malaria with specific focus on multi-organ dysfunction (MODS). In this cross-sectional study confirmed cases of malaria were enrolled.Results: Plasmodium vivax malaria was the predominant type seen in 74.1% cases. The overall prevalence of thrombocytopenia was 61.5%, hepatic dysfunction 58%, cerebral malaria 16.1%, Hypoglycemia 7.5%, bleeding 34.5%, acute respiratory distress syndrome (ARDS) 5.7% and acute kidney injury (AKI) 49.4%. Hypoglycemia was significantly higher in mixed malaria (0.025, p = 0.025). Hepatic dysfunction and hyperbilirubinemia were significantly higher in mixed malaria (p=0.001). Mortality was seen in mixed malaria (p = 0.007). Only those with mixed malaria died (13%). Patients with MODS had higher prevalence of rashes (p <0.0001) and cerebral malaria (p = 0.000). Serum levels of urea, creatinine, Bilirubin, Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) were significantly higher in patients with MODS (p<0.0001 for all variables). On evaluating factors associated with multi-organ dysfunction presence of cerebral malaria [OR: 6.4 (95% CI): 2.4 to 17.4; p<0.0001], type of malaria (Vivax or Falciparum or both) [1.77 (1.03 to 3.03); p=0.0038], and hypoglycemia [4.4 (1.08 to 17.8); p=0.038] were statistically significant on multivariate analysis.Conclusions: The present study demonstrates the factors associated with multi organ dysfunction and its impact on clinical outcome in different types of malaria.
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Nauriyal, Deepty, and Deepak Kumar. "Study of Severe Malaria Caused by Plasmodium Vivax in Comparison to Plasmodium Falciparum and Mixed Malarial Infections in Children." Biomedical and Pharmacology Journal 15, no. 3 (September 29, 2022): 1597–604. http://dx.doi.org/10.13005/bpj/2498.
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Background: Malaria alone is responsible for major proportion of morbidity and mortality in children. Most cases of malaria are due to P.vivax. P.vivax has always been considered benign but recent studies and molecular studies are giving evidences towards increasing virulence and severity of P.vivax Aims and objective: Aim of this study was to observe severe malaria caused by P.vivax in comparison to Falciparum and mixed malarial infections. Other added aim was to observe for concomitant bacterial infections, how it affects clinical outcome and role of antibiotics in such cases of severe malaria. Materials and methods: This was a hospital based study conducted in a tertiary care center in Uttar Pradesh. Patients were tested for malaria using Peripheral blood smear and Rapid malaria antigen test. Total of 200 cases of severe malaria were enrolled in study. Patients were categorized as severe malaria on basis of WHO guidelines. Results: Of 200 cases of severe malaria, 130 (65%) had P.vivax infection, 31 (15.5%) had falciparum infection and 39 (19.5%) had mixed infection with both the species. Noteworthy results observed in cases of severe malaria with P.vivax infections were cerebral malaria (29.2%), severe anemia (26.9 %), severe thrombocytopenia (7.6%) and mortality (13%). Almost 15 % of total patients had concomitant bacterial infections that contributed significantly towards morbidity and prolonged hospitalization. Conclusion: From our study we observed that P.vivax cannot more be considered benign and needs quick diagnosis, prompt treatment and should be observed for complications. Antibiotics use should be considered in severe malaria.
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Ndefo, J. C., I. U. Okagu, C. O. Agbowo, L. N. Eneje, and P. C. Nnorom. "Alcohol overuse increases susceptibility to malaria and its complications: a pilot study." Nigerian Journal of Parasitology 42, no. 2 (October 15, 2021): 194–205. http://dx.doi.org/10.4314/njpar.v42i2.2.
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Malaria has remained a dangerous disease that has been posing great burden to man and his wellbeing. Several factors influence the susceptibility to this disease including genetic and environmental determinants. The role of alcohol on malaria parasite infection and its complications is not well-defined. It is established that malaria infection and alcohol independently influence the immune system of man and other animals. Therefore, it is logical to reason that their combined influence may be additive. The aim of this study was to investigate the effect of alcohol on determinants of malaria infection in mice. Nine groups of mice (n = 5) were used with group one serving as normal control, group 2 (alcohol control) received 12 g/kg b.w/d. of 50% absolute ethanol p.o only for 7 days and group 3 was parasitized only (parasite control). Groups 4-6 received 12 g/kg b.w/d. of 10, 30 and 50% ethanol, respectively for 7 days prior to parasite inoculation. Similarly, groups 7-9 were parasitized and thereafter received 12 g/kg b.w/d. of 10, 30 and 50 % ethanol, respectively 24-h after parasite inoculation till the next 7 days. In each case, malaria infection was confirmed 72-h post-inoculation. Thereafter, overnight fasted blood samples were analyzed for malaria parasitemia (malaria parasite density), hematological indices (hemoglobin concentration, packed cell volume and erythrocyte and leukocyte counts), lipid profile (total cholesterol, triacylglycerol, low and high density lipoproteins), and liver (alanine and aspartate aminotransferases and total bilirubin) and kidney (urea and creatinine) status using standard methods. The results of various analyzed parameters in alcohol exposed mice infected with malaria parasite were compared with mice exposed to alcohol and malaria parasite alone using one-way analyses of variance. The result showed that parasitized alcohol-treated mice had higher malaria parasitemia (34.33 ± 2.53, 39.49 ± 1.71 and 54.12 ± 2.76 x104 parasites/μL, respectively for 10, 30 and 50 % ethanol) relative to parasitized mice not treated with alcohol (22.01 ± 1.35 x104 parasites/μL). In addition, concentration-based reduction in hematological status (packed cell volume, hemoglobin concentration, and erythrocyte and leukocyte counts) was observed in alcohol-fed parasitized mice relative to parasite only and alcohol only controls. Furthermore, biochemical status indicating dyslipidemia as characterized by the elevation in total cholesterol, low density lipoprotein and triacylglycerol concentrations and decrease in high density lipoprotein level, hypoglycemia, renal and hepatic dysfunctions as indicated by increase in liver function markers as well as creatinine and urea levels in serum were observed in infected mice treated with alcohol relative to parasite only and alcohol only controls. In conclusion, this observation suggests that alcohol overuse exacerbates malaria parasitemia and suppresses immune response to malaria parasites, in a concentration-dependent manner, thereby promoting the progression and severity of complications associated with malaria. Further study to investigate the mechanism behind this preliminary observation is warranted.
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Schwarzer, Evelin, Paolo Arese, and Oleksii A. Skorokhod. "Role of the Lipoperoxidation Product 4-Hydroxynonenal in the Pathogenesis of Severe Malaria Anemia and Malaria Immunodepression." Oxidative Medicine and Cellular Longevity 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/638416.
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Oxidative stress plays an important role in the pathogenesis offalciparummalaria, a disease still claiming close to 1 million deaths and 200 million new cases per year. Most frequent complications are severe anemia, cerebral malaria, and immunodepression, the latter being constantly present in all forms of malaria. Complications are associated with oxidative stress and lipoperoxidation. Its final product 4-hydroxynonenal (4-HNE), a stable yet very reactive and diffusible molecule, forms covalent conjugates with proteins, DNA, and phospholipids and modulates important cell functions at very low concentrations. Since oxidative stress plays important roles in the pathogenesis of severe malaria, it appears important to explore the role of 4-HNE in two important malaria complications such as malaria anemia and malaria immunodepression where oxidative stress is considered to be involved. In this review we will summarize data about 4-HNE chemistry, its biologically relevant chemical properties, and its role as regulator of physiologic processes and as pathogenic factor. We will review studies documenting the role of 4-HNE in severe malaria with emphasis on malaria anemia and immunodepression. Data from other diseases qualify 4-HNE both as oxidative stress marker and as pathomechanistically important molecule. Further studies are needed to establish 4-HNE as accepted pathogenic factor in severe malaria.
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Obonti, Anika Tabassum, Safaet Alam, Taslima Binte Kamal, Anika Zaman, Hasin Hasnat, Tanoy Saha, and Md Ashraful Islam. "Prospective Plants with Corroborated Antimalarial Actions: A Review." Bangladesh Pharmaceutical Journal 24, no. 2 (July 10, 2021): 180–93. http://dx.doi.org/10.3329/bpj.v24i2.54716.
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Malaria is a serious illness resulted from parasites that are communicated to people through the bites of infected female Anopheles mosquitoes. Malaria is still in a worrying trend, particularly in tropical and subtropical climates although it is curable and preventable. In spite of a noteworthy abetment in incidence and death rates caused by malaria, even in 2017, a big number of people (219 million) have been affected by it along with 435 thousand confirmed death cases. Though a lot of synthetic drugs have been commercialized to treat malaria, those are compromised with some serious side effects. On the contrary, plant sources are always getting a big focus to develop novel and effective therapeutics in the treatment of different ailments i.e. quinine and artemisinin to treat malarial complications. The usage of herbal plants against malaria has also a very ancient root. Several families of plant species have showed potential antimalarial activities in previous research works. In this review work, families of these plants have been compiled so that prospective researchers can find a hint to discover more effective and safer plant-derived therapeutic options against malaria.
Bangladesh Pharmaceutical Journal 24(2): 180-193, 2021
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Awasthi, Kiran Raj, Jonine Jancey, Archie C. A. Clements, and Justine E. Leavy. "A qualitative study of knowledge, attitudes and perceptions towards malaria prevention among people living in rural upper river valleys of Nepal." PLOS ONE 17, no. 3 (March 18, 2022): e0265561. http://dx.doi.org/10.1371/journal.pone.0265561.
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Background Nepal has made significant progress in decreasing the number of malaria cases over the last two decades. Prevention and timely management of malaria are critical for the National Malaria Program in its quest for elimination. The study aimed to explore the knowledge, attitudes and behaviour towards malaria prevention and treatment among people living in rural villages of Khatyad Rural Municipality in Nepal. Methods This qualitative study collected information through virtual in-depth interviews (N = 25) with female and male participants aged between 15 and 72 years. Results More than half of the participants knew about the causes of malaria, were aware of the complications of untreated malaria and knew that anti-malarial medicines were provided for free at the public health facilities. Participants indicated that their first choice of health care were public health facilities, however limited supply of medications and diagnostics deviated patients to the private sector. While tertiary care costs were not financially viable, participants opted against traditional care for malaria. Factors such as cost of treatment, distance to the health facility and the decision making authority in households influenced health related decisions in the family. Although long-lasting insecticidal nets were distributed and indoor residual spraying was done periodically, several barriers were identified. Conclusion Increased awareness of malaria prevention and treatment among people living in malaria risk areas is important for the National Malaria Program in its quest for malaria elimination in Nepal.
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Ahmad, Sohaib, Nadia Shirazi, Nowneet Kumar Bhat, Minakshi Dhar, Garima Mittal, Manish Mittal, Nidhi Kaeley, and Manoj Kumar. "A HOSPITAL-BASED RETROSPECTIVE COMPARATIVE STUDY OF COMPLICATIONS, OUTCOMES, CLINICAL AND LABORATORY PARAMETERS OF MALARIA WITH AND WITHOUT NEUROLOGICAL INVOLVEMENT." Mediterranean Journal of Hematology and Infectious Diseases 9, no. 1 (December 26, 2016): e2017006. http://dx.doi.org/10.4084/mjhid.2017.006.
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Background & Objectives: Classically associated with Plasmodium falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign Plasmodium vivax for causing severe malaria as well. We aimed to analyze the cerebral complications in malaria, and study if there is a specie-related difference in the presentation and outcomes.Methods: We retrospectively compared patients of malaria hospitalised from 2009-15, with (n=105) and without (n=1155) neurological involvement in terms of outcomes, complications, demographic attributes, clinical features, and laboratory parameters. Subsequently, the same parameters were studied in those with cerebral malaria due to mono-infections of vivax or falciparum and their co-infection.Results: Cerebral malaria was observed in 8.3% (58/696), 7.4% (38/513) and 17.6% (6/51) of vivax, falciparum and combined plasmodial infections respectively. Those with cerebral malaria had significantly (p<0.05) longer hospitalization, delayed defervescence, required mechanical ventilatory support and dialysis despite comparable levels of azotemia and renal insufficiency, and adverse outcomes compared to non-cerebral malaria. Severe thrombocytopenia, respiratory distress and mechanical ventilation were significantly (p<0.05) associated with P. vivax cerebral malaria.Conclusions:The plasmodial species were comparable in clinical and laboratory parameters and outcomes in cerebral malaria in isolation and in combination (p>0.05). P. vivax emerged as the predominant cause of cerebral malaria and its virulence was comparable to P. falciparum.
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Batool, Yasmeen, Sabeen Fatima, Gulzaib Pervaiz, Naseem Akhtar, Maliha Asif, and Faisal Bashir. "Frequency of thrombocytopenia and its severity in patients of Malaria." Professional Medical Journal 26, no. 09 (September 10, 2019): 1398–403. http://dx.doi.org/10.29309/tpmj/2019.26.09.691.
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Pakistan is an endemic area for malaria. Malaria is considered to be associated with thrombocytopenia. The frequency of thrombocytopenia varies in different studies. This study was done to determine the frequency of thrombocytopenia among patients with malaria. Objectives: To determine the frequency and severity of thrombocytopenia in patients of malaria. Study Design: Cross-sectional survey. Setting: Pathology Department, Nishtar Medical University, Multan. Period: Eight months; (04-03-2018 to 03-11-2018). Materials & Methods: One hundred and fifty patients with malaria were included in the study. Platelet count of all the patients was done on Sysmex-K167. The patients were categorized according to the presence of thrombocytopenia (yes or no) and the severity of thrombocytopenia (mild, moderate or severe). The data was described as frequency distribution table. Results: The mean age of the patients was 31.81 + 15.31 years. There were 46 (30.7%) female patients and 104 (69.3%) male patients. Thrombocytopenia was present among 103 (68.7%) patients. Mild, moderate and severe thrombocytopenia was found in 60 (58.3%), 24 (23.3%) and 19 (18.4%) patients, respectively. Conclusion: This study concludes that frequency of thrombocytopenia is very high among patients with malaria. Severity of thrombocytopenia is mild to moderate, with few patients presenting with severe thrombocytopenia. This finding signifies that malaria is an important cause of thrombocytopenia. So the platelet count should be monitored closely in patients of malaria to avoid possible complications of thrombocytopenia. Moreover, it is suggested that malaria is an important differential diagnosis of thrombocytopenia with fever but needs confirmation by thick and thin smears for malarial parasite. In case of viral infections like dengue fever, smears will be negative for malarial parasite and patients will present with leucopenia and thrombocytopenia and majority of peripheral blood leucocytes will be reactive lymphocytes.
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Jaju, PB, and Shruti B. Bhavi. "Convulsions: Eclampsia or Malaria or Both!" Journal of South Asian Federation of Obstetrics and Gynaecology 7, no. 3 (2015): 245–46. http://dx.doi.org/10.5005/jp-journals-10006-1373.
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ABSTRACT Introduction Prevalence of malaria in pregnancy is 1.4%. A high index of suspicion is most important in the diagnosis of malaria and should be differentiated from other complications like eclampsia, intrauterine sepsis. Case Report Gravida 3 para 2 living 1 (G3P2L1) with 28 weeks gestation was referred with high blood pressure (BP), severe anemia. She was afebrile, severe pallor +, pedal edema +, pulse rate (PR)—110/ min, BP—140/80 mm Hg, per abdomen (P/A)— Ut 28 to 30 weeks size relaxed with fetal heart sounds (FHS) regular. Hemoglobin (HB) 5.3 gm%, platelet count 80,000. After 3 days, patient threw one convulsion. Low dose MgSO4 regime given. Peripheral smear (PS) for malarial parasite (MP) vivax positive and injection quinine 1200 mg in 10% dextrose started. She was induced and delivered. Discussion In pregnancy malaria is more common, more atypical, more severe and more fatal. Once diagnosed treatment should be started immediately and pregnant woman should be given full doses of antimalarials. Both eclampsia and malaria are to be treated. How to cite this article Jaju PB, Bhavi SB. Convulsions: Eclampsia or Malaria or Both! J South Asian Feder Obst Gynae 2015;7(3):245-246.
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Nordmann, Tamara, Saskia Dede Davi, Michael Ramharter, and Johannes Mischlinger. "Quantification of the Proportion of Unfavorable Clinical Outcomes among Imported Malaria Patients According to the Degree of Semi-Immunity on Population Level: An Ecological Study." American Journal of Tropical Medicine and Hygiene 105, no. 2 (August 11, 2021): 477–79. http://dx.doi.org/10.4269/ajtmh.21-0196.
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ABSTRACT. The protective effect of semi-immunity to alleviate clinical complications of malaria remains incompletely understood. This ecological study quantified the proportion of unfavorable clinical outcomes among patient populations with imported malaria as a function of the reported proportion of absent semi-immunity in a patient population. Group-level proportions were extracted from published studies on imported malaria. Linear regression analyses demonstrate a consistent positive trend between the average proportion of absent semi-immunity in patient populations of imported malaria and the proportion of unfavorable clinical outcomes therein. Regression equations provide a group-level estimate of attributable fractions of clinical complications resulting from absent semi-immunity to malaria.
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Bellazreg, Foued, Dorsaf Slama, Nadia Ben Lasfar, Maha Abid, Houneida Zaghouani, Sana Rouis, Wissem Hachfi, and Amel Letaief. "Neurological manifestations following cured malaria: don’t forget post-malaria neurological syndrome." African Health Sciences 21, no. 1 (April 16, 2021): 273–6. http://dx.doi.org/10.4314/ahs.v21i1.35.
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Introduction: Cerebral malaria which occurs during the active infection is the most common neurological complication of malaria. Other complications including post-malaria neurological syndrome (PMNS) can rarely occur following complete recovery from the disease. We report a case of post-malaria neurological syndrome in a Tunisian patient.
Case presentation: A 26-year-old Tunisian man with no past medical history was admitted in 2016 for a muscle weakness of the 4 limbs, seizures, tetraparesis and myoclonus which appeared after he returned from Côte d’Ivoire where he had been treated three weeks ago for Plasmodium falciparum malaria with favorable outcome. Blood smears for malaria were negative. Brain MRI showed multiple hypersignal cerebral lesions. Investigations didn’t show any infectious, metabolic, toxic, vascular or tumoral etiology. Thus, the diagnosis of PMNS was considered. The patient was treated with methylprednisolone with favorable outcome. Two years later, he was completely asymptomatic.
Conclusion: PMNS should be considered in patients with neurological symptoms occurring within two months of cured acute disease in which blood smears for malaria are negative and other etiologies have been ruled out. In most cases, the disease is self-limited while in severe cases corticosteroid therapy should be prescribed with favorable outcome.
Keywords: Post-malaria neurological syndrome; immunologic; corticosteroid.
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Ahmed, Mejbah Uddin, Mohammad Akram Hossain, Abul Hossain Khan, and Salah Uddin Ahmed. "Efficacy of Immunodiagnosis of Falciparum Malaria at Different Levels of Parasitemia." Journal of Enam Medical College 3, no. 2 (August 7, 2013): 88–90. http://dx.doi.org/10.3329/jemc.v3i2.16130.
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Background: Among the several human species of malarial parasites, Plasmodium falciparum can cause severe infection and if left untreated, there may be fatal complications. Early diagnosis and prompt treatment have been proposed to reduce the morbidity and mortality from malaria. Objective: To assess the diagnostic efficacy of antigen detection by immunochromatographic test (ICT) at different levels of parasitemia for diagnosis of malaria. Materials and Methods: This study was carried out in the department of Microbiology, Mymensingh Medical College for a period of one year from July 2005 to June 2006. A total of 98 clinically suspected malaria patients were included in this study. Peripheral blood films (PBF) were examined under microscope and parasite count/?L of blood was performed. Subsequently ICT for malaria antigen was done for each case. Results: Out of 59 cases positive by microscopic examination of blood films, 54 cases had parasitemia >600 parasites/?L of blood and all these cases were positive by ICT for malaria antigen. Rest 5 cases showed parasitemia <600 parasites/?L of blood and one case was found positive by ICT for malaria antigen. Conclusion: Immunochromatographic test can be used for early diagnosis of malaria with hyperparasitemia, especially for cerebral malaria. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 88-90 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16130
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Anand, G. Keshava, and Mallikarjun Rao Sanda. "Complicated malaria: relationship of complications and parasite load to outcome." International Journal of Advances in Medicine 5, no. 1 (January 18, 2018): 186. http://dx.doi.org/10.18203/2349-3933.ijam20180082.
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Background: The incidence of complicated malaria cases is increasing day by day. Complicated malaria present in different ways in different places globally. If malaria is diagnosed and treated immediately, then the death rate is less than one percent. The objective was to study the relationship of complications and parasite load to outcome (mortality) among patients with complicated malaria.Methods: The present hospital based Prospective Observational study was carried out among 100 cases of “Complicated malaria.” The present study was carried out at Department of General medicine, Kamineni hospitals, L. B. Nagar, Hyderabad.Results: 71% patients were infected with Plasmodium falciparum, 25% with Plasmodium vivax and 4% with both Plasmodium falciparum and vivax. 12% patients deceased and 88% survived. The relationship between GCS, convulsions, pH, bicarbonate, lactate, hemoglobin, creatinine, SBP, PaO2/FiO2 ratio, PT, INR, aPTT, and outcome was statistically highly significant (p=0.000). The relationship between Total Bilirubin, RBS and outcome was statistically not significant (p=0.351). Multivariate analysis using logistic regression model, to determine the effect of studied variables on the final outcome, revealed no significant influence of studied variables in predicting the outcome (p>0.05). The relationship between increasing parasite load and outcome was studied, and it showed it was statistically highly significant (p=0.000).Conclusions: The prognosis and outcome of patients with complicated malaria worsen as the parasite load increases and the probability of death increases markedly in such patients. The presentation of inappropriate parameters at admission, aid us in predicting poor outcome and appropriate treatment plan.
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Chamnanchanunt, Supat, Pravinwan Thungthong, Sirvicha Kudsood, Waraporn Somwong, and Manassamon Hirunmassuwan. "Autoimmune hemolytic anemia and autoantibodies in a patient with Plasmodium falciparum infection: report of a rare case and review of the literature." Asian Biomedicine 11, no. 5 (October 10, 2018): 427–32. http://dx.doi.org/10.1515/abm-2018-0018.
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AbstractBackgroundAnemia is a common problem among patients with malaria infection, which induces hemolysis during treatment. A few patients present with autoimmune hemolytic anemia (AIHA) and autoantibodies, such as autoanti-E and autoanti-I, during malaria infection.ObjectiveTo report the clinical response of a patient with Plasmodium falciparum malaria infection with a hemolytic condition.MethodsWe reviewed medical records of a patient with P. falciparum malaria and related literature.ResultsOur patient presented with P. falciparum malaria infection and received artesunate and ceftriaxone to cover potential tropical infectious diseases. After malaria parasite was eradicated, her hemoglobin declined, and AIHA and autoantibodies were found, explaining the cause of anemia. Corticosteroid was given at a standard dosage, and her hemoglobin became normal within 1 week.ConclusionPatients with falciparum malaria and both AIHA and autoantibody complications are rare. Our patient responded to malaria eradication and corticosteroid treatment. Most cases reported seem to respond to corticosteroid with a variety of recovery times. However, corticosteroids might increase the severity of infection; more clinical data to support a standard regimen to treat properly rare hematologic complications (AIHA and autoantibodies) in malaria patients are warranted.
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Geleta, Getachew, and Tsige Ketema. "Severe Malaria Associated with Plasmodium falciparum and P. vivax among Children in Pawe Hospital, Northwest Ethiopia." Malaria Research and Treatment 2016 (March 7, 2016): 1–7. http://dx.doi.org/10.1155/2016/1240962.
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Despite rigorous effort made to control malaria for more than a century, it is still among the main public health problems in least developed regions of the world. Majority of deaths associated with malaria occur in sub-Sahara Africa among biologically risked groups. Thus, this study was designed to assess the incidence of severe malaria syndromes among children in Pawe Hospital, Northwest Ethiopia. Children seeking medication for malaria infection in Pawe Hospital during the study period were recruited. Sociodemographic characteristics, physical, hematological, and clinical features of complicated malaria were assessed following standard parasitological and clinical procedures. A total of 263 children were found malaria positive. Among these, 200 were infected with Plasmodium falciparum. Most of the severe malaria symptoms were observed among children infected with P. falciparum and P. vivax. The study showed that significant number of the children developed severe life threatening malaria complications. This calls for prompt early diagnosis and effective treatment of patients to reduce mortality and complications associated with malaria in the study site.
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Ghanghoriya, Pawan, Rahul Borkar, Monica Lazarus, and Manish Ajmariya. "Study of malaria and associated co-morbidity in children admitted with fever manifestation in a tertiary care centre." International Journal of Contemporary Pediatrics 7, no. 8 (July 22, 2020): 1705. http://dx.doi.org/10.18203/2349-3291.ijcp20203161.
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Background: Children under five year of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with anti-malarial medications. Authors set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in tertiary care center NSCB Medical college Jabalpur, India.Methods: This prospective and analytic study focused on children admitted with fever in pediatric unit of N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India. If any co-morbidity present with malaria their manifestation was noted. Association of co-morbidity with malaria was done, and effect of co-morbidity on severity of malaria and outcome of patients was noted.Results: A total number of 1950 of children suspected to have malaria who were tested by RDT and microscopy (PSMP), out of them 100 children were positive. Mean age calculated was 7.3±4.3 years. Maximum number of severe malaria cases (40.6%) were found in 6 months to <5 years age group. Most common co-morbidity associated with malaria was anemia (53%) followed by pneumonia (36%) hepatitis (26%), diarrhea (24%), enteric fever (15%), septicemia and meningoencephalitis (10%) each, UTI (4%), and AKI (6%), while dengue (3%) and severe acute malnutrition (2%). Out of 69 cases of severe malaria 46.3% cases had two and 34.7% cases had more than two co-morbidities while in 31 cases of uncomplicated malaria 38.7% cases had two co-morbidity and only 3% had more than two co-morbidity.Conclusions: All RDT positive cases have associated co-morbidity with malaria in our study, more is the co-morbidity is longer were the duration of stay and higher the complications and even mortality.
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Zingman, B. S., and B. L. Viner. "Splenic Complications in Malaria: Case Report and Review." Clinical Infectious Diseases 16, no. 2 (February 1, 1993): 223–32. http://dx.doi.org/10.1093/clind/16.2.223.
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