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Parikh, Harvy, Ravi Shah, Nilesh Doctor, and Hemant Shah. "A study of serum calcium level in cases of malaria in a tertiary care hospital." International Journal of Advances in Medicine 8, no. 12 (2021): 1827. http://dx.doi.org/10.18203/2349-3933.ijam20214518.
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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.
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Mandala, Wilson L., Chisomo L. Msefula, Esther N. Gondwe, et al. "Lymphocyte Perturbations in Malawian Children with Severe and Uncomplicated Malaria." Clinical and Vaccine Immunology 23, no. 2 (2015): 95–103. http://dx.doi.org/10.1128/cvi.00564-15.
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ABSTRACTLymphocytes are implicated in immunity and pathogenesis of severe malaria. Since lymphocyte subsets vary with age, assessment of their contribution to different etiologies can be difficult. We immunophenotyped peripheral blood from Malawian children presenting with cerebral malaria, severe malarial anemia, and uncomplicated malaria (n= 113) and healthy aparasitemic children (n= 42) in Blantyre, Malawi, and investigated lymphocyte subset counts, activation, and memory status. Children with cerebral malaria were older than those with severe malarial anemia. We found panlymphopenia in children presenting with cerebral malaria (median lymphocyte count, 2,100/μl) and uncomplicated malaria (3,700/μl), which was corrected in convalescence and was absent in severe malarial anemia (5,950/μl). Median percentages of activated CD69+NK (73%) and γδ T (60%) cells were higher in cerebral malaria than in other malaria types. Median ratios of memory to naive CD4+lymphocytes were higher in cerebral malaria than in uncomplicated malaria and low in severe malarial anemia. The polarized lymphocyte subset profiles of different forms of severe malaria are independent of age. In conclusion, among Malawian children cerebral malaria is characterized by lymphocyte activation and increased memory cells, consistent with immune priming. In contrast, there are reduced memory cells and less activation in severe malaria anemia. Further studies are required to understand whether these immunological profiles indicate predisposition of some children to one or another form of severe malaria.
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Kotepui, Kwuntida Uthaisar, Pattamaporn Kwankaew, Frederick Ramirez Masangkay, Aongart Mahittikorn та Manas Kotepui. "Transforming Growth Factor-β Concerning Malarial Infection and Severity: A Systematic Review and Meta-Analysis". Tropical Medicine and Infectious Disease 7, № 10 (2022): 299. http://dx.doi.org/10.3390/tropicalmed7100299.
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Transforming growth factor-β (TGF-β) is important in the pathophysiology of malaria, but its role in acute and severe malaria is largely unknown. As a result, this study used a meta-analysis approach to investigate the difference in TGF-β levels between several groups of malaria patients and healthy controls. The systematic review protocol was registered at PROSPERO (ID: CRD42022318864). From inception to 7 March 2022, studies that reported TGF-β levels in patients with uncomplicated and healthy controls and patients with severe and uncomplicated malaria were searched in PubMed, Scopus and Embase. The assessment of the quality of the included studies was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Qualitative and quantitative syntheses were performed to narratively describe and quantitatively pool the mean difference (MD) in TGF-β levels between uncomplicated malaria and healthy controls, and between severe and uncomplicated malaria, using a random-effects model. A total of 1027 relevant articles were identified, and 13 studies were included for syntheses. The meta-analysis results show 233 patients with uncomplicated malaria and 239 healthy controls. Patients with uncomplicated malaria (233 cases) had lower mean TGF-β levels than healthy controls (239 cases; p < 0.01, pooled MD = −14.72 pg/mL, 95% confidence interval (95% CI) = −20.46 to 8.99 pg/mL, I2 = 98.82%, seven studies). The meta-analysis found no difference in mean TGF-β levels between patients with severe malaria (367 cases) and patients with uncomplicated malaria (180 cases; p = 0.11, pooled MD = −6.07 pg/mL, 95% CI = −13.48 to 1.35 pg/mL, I2 = 97.73%, six studies). The meta-analysis demonstrated decreased TGF-β levels in patients with uncomplicated malaria compared to healthy controls. In addition, no difference in TGF-β levels was found between patients with severe and uncomplicated malaria. More research is needed to determine whether TGF-β levels could be a candidate marker for malarial infection or disease severity.
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O.A., Elakhe, Isere A.O., and Akerejola R.F. "Mathematical Model of Malaria Transmission with Anti-Malarial Herbal Therapy as Control." African Journal of Mathematics and Statistics Studies 6, no. 3 (2023): 1–16. http://dx.doi.org/10.52589/ajmss-1276jr4u.
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Conventional anti–malarial drugs (chloroquine, Artesunate, Quinine, Amodiaquine etc) are used by most malaria-endemic countries as first-line treatment for uncomplicated malaria. However, resistance by plasmodium parasite against these conventional anti–malarial drugs has necessitated the need for herbal medicine as alternative. So in this study, we formulate a mathematical model of malaria transmission in two interacting population of human (host) and mosquito (vector) incorporating anti-malarial herbal therapy as first line treatment for uncomplicated malaria infection. The region where the model is epidemiological feasible and mathematically well–posed is established and the basic reproduction number R_0 is derived using next generation matrix approach. The numerical experiment carried out to access the impact of the control measure on malaria transmission revealed a reduction in the number of complicated infectious human population. Hence this research work suggests a massive campaign on use of anti-malarial herbal therapy as first- line treatment for malaria infection cases.
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Lyke, Kirsten E., Robin B. Burges, Yacouba Cissoko, et al. "HLA-A2 Supertype-Restricted Cell-Mediated Immunity by Peripheral Blood Mononuclear Cells Derived from Malian Children with Severe or Uncomplicated Plasmodium falciparum Malaria and Healthy Controls." Infection and Immunity 73, no. 9 (2005): 5799–808. http://dx.doi.org/10.1128/iai.73.9.5799-5808.2005.
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ABSTRACT Understanding HLA-restricted adaptive host immunity to defined epitopes of malarial antigens may be required for the development of successful malaria vaccines. Fourteen epitopes of preerythrocytic malarial antigens known to mediate cytotoxic T-lymphocyte responses against target cells expressing HLA-A2-restricted epitopes were synthesized and pooled based on antigen: thrombospondin-related anonymous protein (TRAP), circumsporozoite protein (CSP), and export protein 1 (Exp-1) peptides. HLA-A2 supertype (*0201, *0202, *0205, *6802) peripheral blood mononuclear cells collected from 774 Malian children, aged 3 months to 14 years, with severe Plasmodium falciparum malaria matched to uncomplicated malaria or healthy controls were stimulated with the HLA-A2-restricted peptide pools. Significant gamma interferon production, determined by enzyme-linked immunospot assay to at least one of the three peptide pools, was observed in 24/58 (41%) of the severe malaria cases, 24/57 (42%) of the uncomplicated malaria cases, and 34/51 (67%) of the healthy controls. Significant lymphoproliferation to these peptides was observed in 12/44 (27%) of the severe malaria cases, 13/55 (24%) of the uncomplicated malaria cases, and 18/50 (36%) of the healthy controls. Responses to individual peptide pools were limited. These studies confirm the presence of adaptive cell-mediated immunity to preerythrocytic malaria antigens in volunteers from Mali and demonstrate that suballeles of the HLA-A2 supertype can effectively present antigenic epitopes. However, whether these immune responses to TRAP, CSP, and Exp-1 malarial proteins play a substantial role in protection remains a matter of controversy.
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Gordeuk, Victor R., Ishmael Kasvosve, Janneke van Dijk, et al. "Altered Immune Response in Severe Malaria Anemia in Children." Blood 108, no. 11 (2006): 1303. http://dx.doi.org/10.1182/blood.v108.11.1303.1303.
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Abstract We prospectively assessed immune markers in children &lt;6 years with severe malarial anemia (hemoglobin &lt;5.0 g/dL; n = 72) and uncomplicated malaria (n = 69) who presented to Macha Mission Hospital in Zambia’s Southern Province. We also studied 70 children &lt;6 years who presented to well child clinics in Harare, Zimbabwe as controls. Compared to controls, children with uncomplicated malaria had significantly higher temperatures and parasite counts, lower hemoglobin and platelet concentrations, higher plasma levels of interferon-gamma, tumor necrosis factor alpha, and interleukin 10 and lower levels of monocyte inhibitory factor (MIF). Compared to uncomplicated malaria, severe malaria anemia was associated with younger age, longer duration of fever and lower temperature on admission. Reticulocyte index and serum concentrations of bilirubin and LDH did not differ between the malaria groups, suggesting that unusually severe extra- or intra-medullary hemolysis did not explain the severe anemia. Higher white blood cell and platelet counts in the severe malaria group suggested that pan-suppression of the marrow was also not the primary cause. Of originally selected measures of inflammation, plasma levels of TNF-alpha and MIF did not differ between the malaria groups, but concentrations of both interferon-gamma and interleukin-10 were significantly lower in the severe anemia group (P &lt;0.006). Additional testing revealed levels of interleukin-1alpha, interleukin-6, and IP-10 to be lower and levels of sFAS to be higher in the children with severe anemia versus uncomplicated malaria (P &lt;0.0005). In a logistic regression model, severe malarial anemia was associated with younger age (P = 0.010), prior treatment with sulfadoxine/pyrimethamine or traditional medicine (P &lt;0.32), lower levels of Interleukin-10 (P = 0.025) and higher levels of sFAS (P = 0.003) and TNFa (P = 0.013). Our results are consistent with a multifactorial cause of severe malarial anemia, possibly including infection with resistant plasmodia, over-expression of TNF-alpha in conjunction with under-expression of IL-10, and increased apoptosis.
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Mahittikorn, Aongart, Kwuntida Uthaisar Kotepui, Wanida Mala, Polrat Wilairatana, and Manas Kotepui. "Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis." International Journal of Environmental Research and Public Health 19, no. 18 (2022): 11389. http://dx.doi.org/10.3390/ijerph191811389.
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Procalcitonin (PCT), as a marker of malaria severity, remains to be investigated. The present study collated and compared the levels of PCT between patients with severe malaria, uncomplicated malaria, and control participants to assess their role in predicting malaria infection and disease severity. The systematic review was registered at PROSPERO with registration number CRD42021297243. The search for relevant studies that reported PCT in patients with malaria was performed in PubMed, Scopus, and Web of Science. The following meta-analyses were conducted; (1) the pooled mean PCT levels in patients with severe and uncomplicated malaria, and (2) the pooled mean difference in PCT levels between patients with severe and uncomplicated malaria. Fifteen studies were included for qualitative and quantitative syntheses. The meta-analysis results show that the pooled mean PCT levels in patients with uncomplicated malaria were 3.92 ng/mL (95% CI: 2.26–5.58 ng/mL, I2: 96.5, five studies), whereas the pooled mean PCT levels in patients with severe malaria were 14.13 ng/mL (95% CI: 8.75–19.5 ng/mL, I2: 92.6, six studies). The meta-analysis showed that patients with severe malaria had an equal mean of PCT compared to those with uncomplicated malaria when the random-effects model was used (p: 0.055, weighted mean difference: 6.93, 95% CI: −0.16–14.02, I2: 84.6%, four studies). There were probable correlations between the level of parasitemia, immunity level, and possibly bacterial or other parasitic co-infection that could affect the PCT level among different clinical severities of malaria. Therefore, the PCT level alone does not seem to be a suitable biomarker to discriminate the severe/uncomplicated or infected/uninfected cases. Further studies should investigate the increased PCT levels in combination with other markers in association with malaria infection and severity.
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Meremikwu, M., F. Odey, C. Oringanje, et al. "Effectiveness of a 6-dose regimen of Artemether-Lumefantrine for unsupervised treatment of uncomplicated childhood malaria in Calabar, Nigeria." Nigerian Journal of Paediatrics 40, no. 2 (2013): 145–49. http://dx.doi.org/10.4314/njp.v40i2.7.
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Background: The six dose regimen of Artemether- Lumefantrine (AL), has high efficacy in clinical trials and is the first -line drug for treating uncomplicated malaria in Nigeria. The complex dosage schedule could militate against its effectiveness.Objective: To assess the effectiveness of AL prescribed under routineoutpatient conditions in the treatment of uncomplicated malaria.Methods: An open label, noncomparative trial to assess the effectivenessof AL in children 6 to 59 months with uncomplicated P. falciparum and parasite density between 1,000 and 250,000/ìL. Enrolled children received 6-dose course of AL (20/120mg tablets). The first dose was administered in the health facility and caregivers were instructed on how to administerthe remaining five doses at home.Results: Of the 1035 screened, 215 eligible children were enrolled and193 completed the study. Twenty two (22) patients withdrew from thestudy (18 were lost to follow-up, 3 violated protocol and 1 withdrewconsent). Adequate clinical and parasitological response (ACPR) was observed in 90.7%; late clinical failure in 7 (3.6%) and late parasitologicalfailure in 11 (5.7%).Conclusion: This study showed high efficacy of AL in treating uncomplicatedP. falciparum malaria in under-fives in Nigeria. Adherence by caregivers to the treatment regimen was quite good and so, should continue to be used in the home setting.Key words: Artemetherlumefantrine, effectiveness, adherence, uncomplicated malaria.
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Lwanira, Catherine N., Fred Kironde, and Göte Swedberg. "Haptoglobin gene diversity and incidence of uncomplicated malaria among children in Iganga, Uganda." Malaria Journal 19, no. 1 (2020): 435. https://doi.org/10.1186/s12936-020-03515-y.
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<strong>Background: </strong>Haptoglobin (Hp) is an acute phase protein that takes part in systemic regulation of haem during <i>Plasmodium falciparum</i> infections. Numerous genotypes of haptoglobin have been reported in malaria endemic populations. In this study, the relationship between haptoglobin genotypes and incidence of uncomplicated malaria in a cohort of children living in a malaria-endemic area of Uganda was determined.<strong>Methods: </strong>This is an extension of a longitudinal study comprising of 423 children aged between six months and nine years, who were actively followed up for one year. Malaria episodes occurring in the cohort children were detected and the affected children treated with national policy drug regimen. Haptoglobin genotypes were determined by an allele-specific PCR method and their frequencies were calculated. A multivariate negative binomial regression model was used to estimate the impact of haptoglobin genotypes on incidence of uncomplicated malaria in the children's cohort. In all statistical tests, a P–value of < 0.05 was considered as significant.<strong>Results: </strong>The prevalence of the Hp 1–1, Hp 2–1 and Hp 2–2 genotypes in the children's cohort was 41%, 36.2% and 22.9%, respectively. The overall frequency for the Hp 1 allele was 59%, while Hp 2 allele occurred at a frequency of 41%. After adjustment of incidence rates for age, insecticide treated bed net (ITN) use and malaria history, the incidence of uncomplicated malaria for children carrying the Hp 2–2 genotype and those with the Hp 2–1 genotype was statistically similar (P = 0.41). Also, no difference in the incidence of uncomplicated malaria was observed between children carrying the Hp 1–1 genotype and those having the Hp 2–1 genotype (P = 0.84) or between Hp 2–2 Vs Hp 1–1 genotypes (P = 0.50).<strong>Conclusions: </strong>This study showed that the Hp 1–1 and Hp 2–1 genotypes each occur in nearly 4 in 10 children and the Hp 2–2 genotype occurs in 2 of every 10 children. No association with incidence of uncomplicated malaria was found. Additional studies of influence of haptoglobin genotypes on <i>P. falciparum</i> malaria severity are needed to understand the role of these genotypes in malarial protection.
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Toovey, Stephen. "Treatment of uncomplicated malaria." Transactions of the Royal Society of Tropical Medicine and Hygiene 96, no. 5 (2002): 573. http://dx.doi.org/10.1016/s0035-9203(02)90447-5.
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Nsiah, Kwabena, Bernard Bahaah, Bright Oppong Afranie, Simon Koffie, Emmanuel Akowuah, and Sampson Donkor. "Oxidative Stress and Hemoglobin Level of Complicated and Uncomplicated Malaria Cases among Children: A Cross-Sectional Study in Kumasi Metropolis, Ghana." Journal of Tropical Medicine 2019 (July 7, 2019): 1–6. http://dx.doi.org/10.1155/2019/8479076.
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Introduction. Malaria is a leading cause of mortality among children below 5 years in Ghana. Its parasites are known to cause the degradation of hemoglobin, resulting in the production of reactive oxygen species and hence oxidant stress. Therefore, this study was carried out to compare the levels of oxidative stress between children with complicated and uncomplicated malaria infection in Kumasi, Ghana. Method. Subjects were recruited from hospitals in the Kumasi Metropolis. This was a cross-sectional study, involving 17 complicated malaria subjects, 51 uncomplicated malaria subjects, and 15 nonparasitemic subjects. The rapid diagnostic test (RDT) was used to determine presence or absence of falciparum malaria among the study participants. Blood samples from subjects were used to determine hemoglobin, malondialdehyde (MDA), and vitamin C levels. Results. Majority of the subjects (67.5%) were within the age of 0-5 years. The mean age (±SD) of uncomplicated malaria subjects was 4.32 (±2.81) years, while that of complicated malaria was 4.27 (±2.96). Mean levels of HB decreased significantly in the following order: control subjects > uncomplicated malaria subjects > complicated malaria subjects (p<0.0001). Mean levels of MDA were significantly lower in control subjects compared to complicated malaria subjects (4.62±1.85 versus 6.68±0.70, p=0.0008) and also lowered in uncomplicated malaria subjects compared to complicated malaria (4.50±1.58 versus 6.68±0.70, p<0.0001). There was a statistically significant reduced mean level of vitamin C (p=0.036) in the following order: control subjects > uncomplicated malaria > complicated malaria subjects. However, for the complicated malaria cases, there were significantly higher mean vitamin C levels in females than in males (p<0.001). Conclusion. Malaria progression increases MDA levels and decreases the ascorbate (vitamin C) and hemoglobin levels. It is recommended that future studies should investigate changes in other antioxidant vitamins, like vitamins A and E.
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Castelino, Dipthi Nishal, and K. Shreedhara Avabratha. "C-reactive protein levels in children with uncomplicated malaria." International Journal of Contemporary Pediatrics 4, no. 2 (2017): 573. http://dx.doi.org/10.18203/2349-3291.ijcp20170712.
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Background: Malaria is one of the biggest burden in terms of morbidity and mortality among all infectious diseases and continues to be a major health problem in India. The objective of this study was to study the levels of C-reactive protein in children with uncomplicated Malaria. To correlate C-reactive protein levels with malaria parasite density and species of Malaria.Methods: Retrospective study was done in Father Muller Medical College, Mangalore, Karnataka. 50 patients below 15 years of age malaria parasite positive by fluorescent test (MPFT) and by Peripheral smear formed the subjects and CRP levels and parasite densities was noted down into the proforma.Results: The age group predominantly was children more than 10 years. Plasmodium vivax was the type of malaria in 60% children. Most common symptoms were fever (100%), chills and rigors (41%), vomiting (48%) and headache (24%). Clinical signs observed were hepatomegaly (30%) and splenomegaly (64%). Mean levels of C reactive protein (CRP) were 42.91%with standard deviation of 31.62. Mean CRP levels were high in children with Falciparum malaria (44.51±34.19).58% had CRP levels ranging from 6-50 mg/l. 50% children with CRP levels >50 mg/L had parasite density of (++++) which is 100 parasites per 1 field of quantitative buffy coat.Conclusions: C-reactive protein levels are markedly elevated in acute malarial infection in paediatric age group.It correlates well with disease severity.
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Nanyunja, Miriam, Juliet Nabyonga Orem, Frederick Kato, Mugagga Kaggwa, Charles Katureebe, and Joaquim Saweka. "Malaria Treatment Policy Change and Implementation: The Case of Uganda." Malaria Research and Treatment 2011 (September 19, 2011): 1–14. http://dx.doi.org/10.4061/2011/683167.
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Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.
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Jimam, Nanloh Samuel, and Nahlah Elkudssiah Ismail. "Predictors of patients' knowledge, attitudes and practices (KAP) regarding uncomplicated malaria in the primary healthcare facilities of Plateau state, Nigeria." Journal of Health Research 34, no. 4 (2020): 329–44. http://dx.doi.org/10.1108/jhr-06-2019-0125.
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PurposeThis study determined factors that influenced patients' knowledge, attitudes and practices (KAP) regarding uncomplicated malaria in primary healthcare (PHC) facilities of Plateau state, Nigeria.Design/methodology/approachThe data of 956 patients treated for uncomplicated malaria in PHC facilities of Plateau state were used for the study. Inferential statistical analyses were conducted to identify factors that influenced patients' KAP on the disease and its management.FindingsThe study revealed age (p < 0.001), level of education (p = 0.012), attitudes (p = 0.007) and practices (p < 0.001) as significant predictors of knowledge outcomes on uncomplicated malaria, while their attitudes towards the disease and its management was predicted by their gender (p = 0.011), occupation (p = 0.049), monthly income (p = 0.018), knowledge (p < 0.001) and practices (p < 0.001). Furthermore, their practices were significantly predicted by monthly incomes (p = 0.043), knowledge (p < 0.001), attitudes (p < 0.001) and number of anti-malarial and adjunct drugs administered to them (p = 0.041).Originality/valueThe study revealed a mixed influence of patients' characteristics on their KAP outcomes. This calls for appropriate intervention measures towards achieving the desired patients' therapeutic outcomes.
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Mathur, Dr Priyanshu, Dr Pankaj Kumar Jain, and Dr B. D. Gupta. "Chloroquine Vs Co-Artemether in Uncomplicated Malaria." Scholars Journal of Applied Medical Sciences 4, no. 6 (2016): 1981–85. http://dx.doi.org/10.21276/sjams.2016.4.6.22.
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Jumba, Bernard Ngoitsi, Mark Webale, Judith Makwali, and Nathan Shaviya. "Red blood cell indices and cytokine levels in complicated pediatric Malaria in unstable malaria transmission area of Vihiga highlands, Kenya." Journal of Hematology and Allied Sciences 4 (June 20, 2024): 38–45. http://dx.doi.org/10.25259/jhas_7_2024.
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Objectives: Complicated pediatric Malaria in unstable transmission regions presents a significant health challenge, necessitating a comprehensive understanding of the associated hematological and immunological alterations. This study aimed to investigate the hematological parameters, chemokine and cytokine response in children with complicated Malaria in an unstable malaria transmission region. Material and Methods: This cross-sectional study was conducted in Vihiga County, Western Kenya, a highland area with unstable malaria transmission. Three hundred and nine children with varied malaria phenotypes were recruited as follows: 82 healthy controls, 171 uncomplicated and 56 complicated malaria. Hematological indices and cytokine levels were measured across the clinical groups. Results: Children with complicated Malaria exhibited significantly lower hemoglobin levels (median, 6.5 g/dL) compared to uncomplicated Malaria (median, 9.9 g/dL) and healthy controls (median, 13.7 g/dL), P < 0.0001. Hematocrit, red blood cell count, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelets were also significantly reduced in complicated Malaria. Conversely, uncomplicated Malaria showed elevated mean corpuscular volume (MCV), while complicated Malaria had higher red cell distribution width, reticulocyte count, lymphocytes, monocytes, and mean platelet volume (MPV). White blood cell count was similar across groups. Regulated upon Activation, Normal T Cell Expressed and Presumably Secreted (RANTES), interleukin (IL)-8, IL-10, and IL-12 were significantly higher in complicated Malaria compared to uncomplicated Malaria and healthy controls. Conversely, macrophage inflammatory protein 1 alpha and macrophage inflammatory protein 1 beta were elevated in uncomplicated Malaria. IL-1β, IL-2, IL-5, IL-6, and interferon-gamma levels were elevated in complicated Malaria, while IL-4 was higher in healthy controls. Conclusion: This study’s results reveal key hematological derangements attributable to complicated Malaria. Hemoglobin, MCV, and MPV seem to be important markers in the characterization of malaria phenotypes. Moreover, complicated Malaria is associated with a dysregulated and exaggerated immune response.
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Bisanzio, Donal, Mamadou Sitan Keita, Alioune Camara, et al. "Malaria trends in districts that were targeted and not-targeted for seasonal malaria chemoprevention in children under 5 years of age in Guinea, 2014–2021." BMJ Global Health 9, no. 2 (2024): e013898. http://dx.doi.org/10.1136/bmjgh-2023-013898.
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BackgroundSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission.ObjectiveWe assessed the programmatic impact of SMC in Guinea’s context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.MethodsUsing routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.ResultsThe CAGR of TPR of all age groups was statistically lower in SMC (median=−7.8%) compared with non-SMC (median=−3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=−22.3%) than in non-SMC (median=−5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.ConclusionEven in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5.
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Wilairatana, Polrat, Pattamaporn Kwankaew, Kwuntida Uthaisar Kotepui, and Manas Kotepui. "Low Interleukin-12 Levels concerning Severe Malaria: A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health 19, no. 15 (2022): 9345. http://dx.doi.org/10.3390/ijerph19159345.
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Although many studies have investigated the role of interleukin (IL)-12 cytokine in the pathogenesis of severe malaria, these studies were based on a limited number of participants, possibly affecting their outcomes. We analyzed the difference in IL-12 levels between patients with severe and uncomplicated malaria through a meta-analysis. A systematic review was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Systematic literature searches were performed between 20 February and 2 March, 2022 in PubMed, Scopus, and Embase to identify studies reporting IL-12 levels in patients with severe and uncomplicated malaria. The quality of included studies was determined using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The pooled mean difference (MD) in IL-12 between patients with severe and uncomplicated malaria was estimated using the DerSimonian–Laird method for the random-effects model. Altogether, 1885 potentially relevant articles were identified, and 10 studies enrolling 654 patients with severe malaria and 626 patients with uncomplicated malaria were included in the meta-analysis. Patients with severe malaria had lower mean IL-12 levels than those with uncomplicated malaria (p = 0.01, MD: −33.62, 95% confidence interval [CI]: −58.79 to −8.45, I2: 99.29%, 10 studies). In conclusion, decreased IL-12 levels might significantly contribute to the development of severe malaria. As most published literature demonstrated the role of IL-12 in animal models, human studies are required to understand the mechanisms involved in low IL-12 levels in patients with severe malaria.
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Bartoloni, Alessandro, and Lorenzo Zammarchi. "CLINICAL ASPECTS OF UNCOMPLICATED AND SEVERE MALARIA." Mediterranean Journal of Hematology and Infectious Diseases 4, no. 1 (2012): e2012026. http://dx.doi.org/10.4084/mjhid.2012.026.
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The first symptoms of malaria, common to all the different malaria species, are nonspecific and mimic a flu-like syndrome. Although fever represents the cardinal feature, clinical findings in malaria are extremely diverse and may range in severity from mild headache to serious complications leading to death, particularly in falciparum malaria. As the progression to these complications can be rapid, any malaria patient must be assessed and treated rapidly, and frequent observations are needed to look for early signs of systemic complications.In fact, severe malaria is a life threatening but treatable disease. The protean and nonspecific clinical findings occurring in malaria (fever, malaise, headache, myalgias, jaundice and sometimes gastrointestinal symptoms of nausea, vomiting and diarrhoea) may lead physicians who see malaria infrequently to a wrong diagnosis, such as influenza (particularly during the seasonal epidemic flu), dengue, gastroenteritis, typhoid fever, viral hepatitis, encephalitis. Physicians should be aware that malaria is not a clinical diagnosis but must be diagnosed, or excluded, by performing microscopic examination of blood films. Prompt diagnosis and appropriate treatment are then crucial to prevent morbidity and fatal outcomes. Although Plasmodium falciparum malaria is the major cause of severe malaria and death, increasing evidence has recently emerged that Plasmodium vivax and Plasmodium knowlesi can also be severe and even fatal.
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Laurens, Matthew B. "The Immunologic Complexity of Growing Up with Malaria—Is Scientific Understanding Coming of Age?" Clinical and Vaccine Immunology 23, no. 2 (2015): 80–83. http://dx.doi.org/10.1128/cvi.00697-15.
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ABSTRACTIn the current issue ofClinical and Vaccine Immunology, Mandala et al. report changes in lymphocyte populations in children with uncomplicated malaria, severe malarial anemia, and cerebral malaria compared to controls (W. L. Mandala et al., Clin Vaccine Immunol 23:95–103, 2016,http://dx.doi.org/10.1128/CVI.00564-15). This commentary discusses the importance of understanding both helpful and detrimental aspects of the antimalarial immune response that are critical to malaria vaccine development and considers how these responses may relate to antimalarial vaccine safety and efficacy.
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Oluboyo, A. O., S. I. Chukwu, B. O. Oluboyo, and O. O. Odewusi. "Evaluation of Angiopoietins 1 and 2 in Malaria-Infested Children." Journal of Environmental and Public Health 2020 (May 26, 2020): 1–5. http://dx.doi.org/10.1155/2020/2169763.
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Background. Malaria could affect people of all ages, most especially young children. The study evaluated the levels of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) which are critical regulators of endothelial activation and integrity with some hematological parameters (total white blood cell counts (WBC), total red blood cell counts (RBC), platelet counts, and malaria parasite density) in malaria-infected children. Method. A total of 92 blood samples from children between the ages of 6 months to 15 years were analyzed. The samples consisted of 30 cases of severe malaria, 40 cases of uncomplicated malaria, and 22 apparently healthy subjects served as control. Serum Ang-1 and -2 levels were determined using the enzyme-linked immunosorbent assay technique. The hematological parameters were determined using the WHO standard. Results. There was significant decrease (p<0.05) in serum Ang-1 of uncomplicated malaria and severe malaria compared with the control, while significant increase (p<0.05) was observed in Ang-2 and Ang-2/Ang-1 ratio in uncomplicated malaria and severe malaria compared with the control. RBC and platelet showed significant decrease, while WBC showed significant increase in severe malaria compared with uncomplicated malaria and control. Conclusion. This study showed that subjects with malaria infection had a significant increase of Ang-2 and Ang-2 : Ang-1 ratio but presented with a significant decrease of Ang-1. Ang-1 and Ang-2 may be used to determine the severity of malaria infection since their levels differ significantly in malaria subjects compared with the control.
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Hitesh, Patel, Patel Dipa, Chugh Sawan, and Thakkar Ramkumar. "Prevalence of Malarial Retinopathy in Adults and its Prognostic Significance." International Journal of Pharmaceutical and Clinical Research 15, no. 7 (2023): 1001–6. https://doi.org/10.5281/zenodo.11672431.
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<strong>Introduction: </strong>Malarial retinopathy is a set of retinal signs in severe malaria due to falciparum malaria. It includes papilloedema, retinal hemorrhages, blurred disc margins, retinal whitening, retinal edema, vascular changes and soft exudates. <strong>Materials & Methods: </strong>This prospective study included retinal examination of 124 adult malaria patients admitted to tertiary care hospital. Retinal haemorrhages and vascular changes, papilloedema, peripheral whitening, and blurring of the disc borders were noted, <strong>Results: </strong>Prevalence of malarial retinopathy was 22.58%. Retinal hemorrhages was the most common feature (88.5% in severe malaria, 0.0% in uncomplicated malaria, 95.6% in cerebral severe malaria, 50.0% in non-cerebral severe malaria). Papilloedema was also significantly higher in cerebral malaria (81.8%) and non-cerebral malaria (25.0%). The case fatality rate of our study was higher (severe malarial – 42.9%, cerebral malaria – 50.0%). Papilloedema (p-0.009), renal failure (p-0.002) and serum lactate level (p-0.001) were significantly associated with mortality. <strong>Conclusion: </strong>Malaria retinopathy is very common in adults with severe malaria, particularly cerebral malaria. When compared to severe non-cerebral malaria, cerebral malaria is more likely to cause haemorrhage and papilloedema. Papilloedema, lactic acidosis, and renal failure all significantly increase the risk of death.
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Kuraeiad, Saruda, Kwuntida Uthaisar Kotepui, Aongart Mahittikorn та ін. "A Systematic Review and Meta-Analysis of MIP-1α and MIP-1β Chemokines in Malaria in Relation to Disease Severity". Medicina 61, № 4 (2025): 676. https://doi.org/10.3390/medicina61040676.
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Background and Objectives: Macrophage inflammatory protein-1α (MIP-1α) and MIP-1β act as signaling molecules that recruit immune cells to sites of infection and inflammation. This study aimed to synthesize evidence on blood levels of MIP-1α and MIP-1β in Plasmodium-infected individuals and to determine whether these levels differ between severe and uncomplicated malaria cases. Materials and Methods: The study protocol was registered in PROSPERO (CRD42024595818). Comprehensive literature searches were conducted in six databases (EMBASE, MEDLINE, Ovid, Scopus, ProQuest, and PubMed) to identify studies reporting blood levels of MIP-1α and MIP-1β in Plasmodium infections and clinical malaria. A narrative synthesis was used to describe variations in MIP-1α and MIP-1β levels between malaria patients and controls and between severe and non-severe malaria cases. Meta-analysis was used to aggregate quantitative data utilizing a random-effects model. Results: A total of 1638 records were identified, with 20 studies meeting the inclusion criteria. Most studies reported significantly higher MIP-1α and MIP-1β levels in malaria patients compared to non-malarial controls. The meta-analysis showed a significant elevation in MIP-1α levels in malaria patients (n = 352) compared to uninfected individuals (n = 274) (p = 0.0112, random effects model, standardized mean difference [SMD]: 1.69, 95% confidence interval [CI]: 0.38 to 3.00, I2: 96.0%, five studies, 626 individuals). The meta-analysis showed no difference in MIP-1α levels between severe malaria cases (n = 203) and uncomplicated cases (n = 106) (p = 0.51, SMD: −0.48, 95% CI: −1.93 to 0.96, I2: 97.3%, three studies, 309 individuals). Conclusions: This study suggests that while MIP-1α and MIP-1β levels are elevated in malaria patients compared to uninfected individuals, these chemokines show a limited ability to differentiate between severe and uncomplicated malaria or predict severe outcomes. Further research is needed to clarify their role in malaria pathogenesis and explore potential clinical applications.
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Amoako-Sakyi, Daniel, Selorme Adukpo, Kwadwo A. Kusi, et al. "A STAT6 Intronic Single-Nucleotide Polymorphism is Associated with Clinical Malaria in Ghanaian Children." Genetics & Epigenetics 8 (January 2016): GEG.S38307. http://dx.doi.org/10.4137/geg.s38307.
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Malaria pathogenesis may be influenced by IgE responses and cytokine cross-regulation. Several mutations in the IL-4/STAT6 signaling pathway can alter cytokine cross-regulation and IgE responses during a Plasmodium falciparum malarial infection. This study investigated the relationship between a STAT6 intronic single-nucleotide polymorphism (rs3024974), total IgE, cytokines, and malaria severity in 238 Ghanaian children aged between 0.5 and 13 years. Total IgE and cytokine levels were measured by ELISA, while genotyping was done by polymerase chain reaction-restriction fragment length polymorphism (RFLP). Compared with healthy controls, heterozygosity protected against clinical malaria: uncomplicated malaria (odds ratios [OR] = 0.13, P < 0.001), severe malarial anemia (OR = 0.18, P < 0.001), and cerebral malaria (OR = 0.39, P = 0.022). Levels of total IgE significantly differed among malaria phenotypes (P = 0.044) and rs3024974 genotypes (P = 0.037). Neither cytokine levels nor IL-6/IL-10 ratios were associated with malaria phenotypes or rs3024974 genotypes. This study suggests a role for rs3024974 in malaria pathogenesis and offers further insights into an IL-4/STAT6 pathway mutation in malaria pathogenesis.
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Patrocínio-Jesus, Rita, João Cunha, Diva Trigo, Bárbara Flor-de-Lima, and Patrícia Pacheco. "Artemether/Lumefantrine for the Treatment of P. malariae in a Patient on Hemodialysis." Case Reports in Medicine 2019 (February 12, 2019): 1–2. http://dx.doi.org/10.1155/2019/1326171.
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The combination of artemether/lumefantrine is indicated for the treatment of acute uncomplicated Plasmodium falciparum malaria. There have been no clinical trials to assess the efficacy of this medication in patients with renal impairment. While it is unlikely that artemether/lumefantrine would be removed during dialysis, clinical experience regarding drug use in this setting is limited. In this article, the authors report successful treatment of Plasmodium malariae malaria on a patient with end-stage kidney disease undergoing hemodialysis.
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Ismail, Nahlah Elkudssiah, Nanloh Samuel Jimam, Khang Wen Goh, Ching Siang Tan, and Long Chiau Ming. "Economic Burdens of Uncomplicated Malaria in Primary Health Care (PHC) Facilities of Plateau State, Nigeria: Patients’ Perspectives." International Journal of Environmental Research and Public Health 20, no. 2 (2023): 1093. http://dx.doi.org/10.3390/ijerph20021093.
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Objectives: This study aims at evaluating the costs incurred by patients in Primary Healthcare facilities of Plateau State, Nigeria, due to uncomplicated malaria management. Methods: Patients’ information on resources used and absence from the labour market due to uncomplicated malaria illness were collected using the self-reported cost of illness instruments across 24 selected Primary Health Care (PHC) facilities in Plateau State. The collated data were used to estimate the direct medical and non-medical costs incurred by patients through the summation of the various costs paid out of pocket for the services; while the indirect cost was estimated using the human capital theory. All analyses were conducted through Microsoft Excel and IBM Statistical Package for Social Sciences (SPSS®) version 23 software. Results: The average direct cost per episode of uncomplicated malaria was estimated at NGN 2808.37/USD 7.39, while the indirect average money equivalence of the time lost due to the ailment was estimated at NGN 2717/USD 7.55, giving an average cost of treating uncomplicated malaria borne by patients in Plateau State per episode to be NGN 5525.37/USD 14.94. The projected annual cost of the disease was NGN 9, 921,671,307.22 (USD 27, 560,198.08). Conclusions: The study showed substantial financial costs borne by patients due to uncomplicated malaria in Plateau State, comprising 50.83% of direct cost and 49.17% of the indirect cost of medications.
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Aguemon, Badirou, Barikissou Georgia Damien, Antoine Vickey Hinson, et al. "Malaria Case-Management in Urban Area: Various Challenges in Public and Private Health Facilities in Benin, West Africa." Open Public Health Journal 11, no. 1 (2018): 54–61. http://dx.doi.org/10.2174/1874944501811010054.
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Background:In Benin, malaria remains endemic and perennial throughout the year in most areas. During the last decade, a substantial increase was noticed in the procurement of Artemisinin-based combination therapies and malaria RDT. This study aimed to evaluate the quality of uncomplicated malaria cases-management in public and private health facilities.Methods:A cross-sectional survey was carried out in public and private health facilities in the municipality of Abomey-Calavi in southern Benin from August to September 2016. The study focused on two targets: (i) patients with uncomplicated malaria who sought care in a health facility in Abomey-Calavi during the study period; and (ii) the health care providers in public and private health facilities authorized by the Ministry of Health.Results:In 27 health facilities investigated, 15 in the public sector and 12 in the private sector, a total of 313 patients and 93 health care providers were included. Forty-four percent (44%) had no education. Among the patients, 60% were identified in the public health facilities. About 87% of uncomplicated malaria patients were tested in public facilities while 63% were tested in private facilities. In the same way, 54% of patients were treated in accordance with National Malaria Control Program (NMCP) guidelines.Conclusions:The present study showed a poor performance in uncomplicated malaria case-management in private health facilities compared to public health facilities. Strategy to improve access and utilization of malaria case-management supplies needs to be reviewed in both public and private health facilities.
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Joste, Valentin, Laurine Maurice, Gwladys I. Bertin, et al. "Identification of Plasmodium falciparum and host factors associated with cerebral malaria: description of the protocol for a prospective, case-control study in Benin (NeuroCM)." BMJ Open 9, no. 5 (2019): e027378. http://dx.doi.org/10.1136/bmjopen-2018-027378.
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IntroductionIn 2016, an estimated 216 million cases and 445 000 deaths of malaria occurred worldwide, in 91 countries. In Benin, malaria causes 26.8% of consultation and hospitalisation motif in the general population and 20.9% in children under 5 years old.The goal of the NeuroCM project is to identify the causative factors of neuroinflammation in the context of cerebral malaria. There are currently very few systematic data from West Africa on the aetiologies and management of non-malarial non-traumatic coma in small children, and NeuroCM will help to fill this gap. We postulate that an accurate understanding of molecular and cellular mechanisms involved in neuroinflammation may help to define efficient strategies to prevent and manage cerebral malaria.Methods and analysisThis is a prospective, case-control study comparing cerebral malaria to uncomplicated malaria and non-malarial non-traumatic coma. This study takes place in Benin, precisely in Cotonou for children with coma and in Sô-Ava district for children with uncomplicated malaria. We aim to include 300 children aged between 24 and 71 months and divided in three different clinical groups during 12 months (from December 2017 to November 2018) with a 21 to 28 days follow-up for coma. Study data, including clinical, biological and research results will be collected and managed using CSOnline-Ennov Clinical.Ethics and disseminationEthics approval for the NeuroCM study has been obtained fromComité National d’Ethique pour la Recherche en santéof Benin (n°67/MS/DC/SGM/DRFMT/CNERS/SA; 10/17/2017). NeuroCM study has also been approved byComité consultatif de déontologie et d’éthiqueof Institut de Recherche pour le Développement (IRD; 10/24/2017). The study results will be disseminated through the direct consultations with the WHO’s Multilateral Initiative on Malaria (TDR-MIM) and Roll Back Malaria programme, through scientific meetings and peer-reviewed publications in scientific or medical journals, and through guidelines and booklets.
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Takyi, Abena, Verena I. Carrara, Prabin Dahal, et al. "Characterisation of populations at risk of sub-optimal dosing of artemisinin-based combination therapy in Africa." PLOS Global Public Health 3, no. 12 (2023): e0002059. http://dx.doi.org/10.1371/journal.pgph.0002059.
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Selection of resistant malaria strains occurs when parasites are exposed to inadequate antimalarial drug concentrations. The proportion of uncomplicated falciparum malaria patients at risk of being sub-optimally dosed with the current World Health Organization (WHO) recommended artemisinin-based combination therapies (ACTs) is unknown. This study aims to estimate this proportion and the excess number of treatment failures (recrudescences) associated with sub-optimal dosing in Sub-Saharan Africa. Sub-populations at risk of sub-optimal dosing include wasted children <5 years of age, patients with hyperparasitaemia, pregnant women, people living with HIV, and overweight adults. Country-level data on population structure were extracted from openly accessible data sources. Pooled adjusted Hazard Ratios for PCR-confirmed recrudescence were estimated for each risk group from published meta-analyses using fixed-effect meta-analysis. In 2020, of the estimated 153.1 million uncomplicated P. falciparum malaria patients in Africa, the largest risk groups were the hyperparasitaemic patients (13.2 million, 8.6% of uncomplicated malaria cases) and overweight adults (10.3 million, 6.7% of uncomplicated cases). The estimated excess total number of treatment failures ranged from 0.338 million for a 98% baseline ACT efficacy to 1.352 million for a 92% baseline ACT efficacy. Our study shows that an estimated nearly 1 in 4 people with uncomplicated confirmed P. falciparum malaria in Africa are at risk of receiving a sub-optimal antimalarial drug dosing. This increases the risk of antimalarial drug resistance and poses a serious threat to malaria control and elimination efforts. Changes in antimalarial dosing or treatment duration of current antimalarials may be needed and new antimalarials development should ensure sufficient drug concentration levels in these sub-populations that carry a high malaria burden.
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Vaughan Williams, C. H., C. La Cock, G. F. J. Henry, and A. J. Ross. "Audit of failure rate of sulfadoxine/pyrimetham combined with chloroquine to treat falciparum malaria at single fourteen-day follow-up." South African Family Practice 25, no. 3 (2002): 4. http://dx.doi.org/10.4102/safp.v25i3.2062.
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Objective: To assess the failure rate of the present first line treatment regime for uncomplicated falciparum malaria of sulfadoxine/pyrimethamine combined with chloroquine.Design: A before-after study.Setting: Ndumo Clinic, Ingwavuma District, South Africa, October 2000 Study Group. 55 patients presenting to Ndumo clinic with uncomplicated malaria and malaria trophozoites visible on thin film.Main outcome measures: Trophozoite count on thick film at day 14.Results: 15 out of 37 patients who returned for follow-up still had trophozoites on thick film. Symptoms of most patients at day 0 and day l4 were mild, parasite counts before and after treatment were low, and trophozoites were atypical.Conclusions: There appears to be an unacceptably high day 14 failure rate with the combination of sulfadoxine/pyrimethamine and chloroguine.The mildness of symptoms, low parasite counts and atypical trophozoites suggest immunity to falciparum malaria amongst the local population. With few antimalarials to chose from, the difficult question as to future treatment of uncomplicated malaria arises.
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Agarwal, Aarti, Aldiouma Guindo, Yacouba Cissoko, et al. "Hemoglobin C associated with protection from severe malaria in the Dogon of Mali, a West African population with a low prevalence of hemoglobin S." Blood 96, no. 7 (2000): 2358–63. http://dx.doi.org/10.1182/blood.v96.7.2358.
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Abstract The malaria hypothesis proposes a survival advantage for individuals with hemoglobin variants in areas of endemicPlasmodium falciparum malaria. Hemoglobin C (HbC) is a possible example in West Africa, where this hemoglobin has a centric distribution with high frequencies among certain populations including the Dogon ethnic group. To test whether HbC is associated with protection from malaria, we performed a case-control study in the Dogon of Bandiagara, Mali. HbC was present in 68 of 391 (17.4%) of uncomplicated malaria control cases, whereas it was detected in only 3 of 67 cases (4.5%) of severe malaria (odds ratio [OR], 0.22;P = .01). Further, HbC was present in only 1 of 34 cases (2.9%) with cerebral manifestations, the most common presentation of severe malaria in this population (OR, 0.14; P = .03). Episodes of uncomplicated malaria and parasitemias (4800-205 050/μL) were identified in cases of homozygous HbC (HbCC), which indicates thatP falciparum parasites are able to efficiently replicate within HbCC erythrocytes in vivo. These findings suggest that HbC does not protect against infection or uncomplicated malaria but can protect against severe malaria in the Dogon population of Bandiagara, Mali. The data also suggest that the protective effect associated with HbC may be greater than that of HbS in this population.
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Agarwal, Aarti, Aldiouma Guindo, Yacouba Cissoko, et al. "Hemoglobin C associated with protection from severe malaria in the Dogon of Mali, a West African population with a low prevalence of hemoglobin S." Blood 96, no. 7 (2000): 2358–63. http://dx.doi.org/10.1182/blood.v96.7.2358.h8002358_2358_2363.
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The malaria hypothesis proposes a survival advantage for individuals with hemoglobin variants in areas of endemicPlasmodium falciparum malaria. Hemoglobin C (HbC) is a possible example in West Africa, where this hemoglobin has a centric distribution with high frequencies among certain populations including the Dogon ethnic group. To test whether HbC is associated with protection from malaria, we performed a case-control study in the Dogon of Bandiagara, Mali. HbC was present in 68 of 391 (17.4%) of uncomplicated malaria control cases, whereas it was detected in only 3 of 67 cases (4.5%) of severe malaria (odds ratio [OR], 0.22;P = .01). Further, HbC was present in only 1 of 34 cases (2.9%) with cerebral manifestations, the most common presentation of severe malaria in this population (OR, 0.14; P = .03). Episodes of uncomplicated malaria and parasitemias (4800-205 050/μL) were identified in cases of homozygous HbC (HbCC), which indicates thatP falciparum parasites are able to efficiently replicate within HbCC erythrocytes in vivo. These findings suggest that HbC does not protect against infection or uncomplicated malaria but can protect against severe malaria in the Dogon population of Bandiagara, Mali. The data also suggest that the protective effect associated with HbC may be greater than that of HbS in this population.
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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 (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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Chiwakata, Collins Batsirai, Christoph Josef Hemmer, and Manfred Dietrich. "High Levels of Inducible Nitric Oxide Synthase mRNA Are Associated with Increased Monocyte Counts in Blood and Have a Beneficial Role in Plasmodium falciparum Malaria." Infection and Immunity 68, no. 1 (2000): 394–99. http://dx.doi.org/10.1128/iai.68.1.394-399.2000.
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ABSTRACT To date, there have been conflicting reports concerning the clinical significance of nitric oxide (NO) in Plasmodium falciparum malaria. Some authors have proposed that NO contributes to the development of severe and complicated malaria, while others have argued that NO has a protective role. To investigate these apparently contradictory reports, reverse transcription-coupled PCR was used to study inducible NO synthase (iNOS) in whole-blood RNA samples from patients with severe and complicated malaria or uncomplicated malaria and from healthy donors. This work produced three principal findings. First, samples of patients with severe and complicated malaria were variably positive, with weak to moderate intensity. Markedly higher iNOS RNA levels were observed in samples of patients with uncomplicated malaria than in patients with severe and complicated malaria. Samples of healthy donors were uniformly negative. Second, since we initially demonstrated iNOS expression in whole-blood RNA samples, we extended our investigations to individual blood cells such as monocytes, lymphocytes, neutrophils, and platelets to identify the cellular source of iNOS. We found that iNOS was expressed predominantly in monocytes. Third, retrospective statistical analysis of monocyte counts clearly demonstrated that patients with uncomplicated malaria had higher monocyte counts at the time of presentation than patients with severe and complicated malaria. Taken together, our findings give room to the interpretation that NO may have a beneficial rather than a deleterious role in falciparum malaria.
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Manirakiza, Alexandre, Siméon Pierre Njuimo, Alain Le Faou, Denis Malvy, and Pascal Millet. "Availability of Antimalarial Drugs and Evaluation of the Attitude and Practices for the Treatment of Uncomplicated Malaria in Bangui, Central African Republic." Journal of Tropical Medicine 2010 (2010): 1–5. http://dx.doi.org/10.1155/2010/510834.
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National malaria management policy is based upon the availability of effective and affordable antimalarial drugs. This study was undertaken to evaluate the quality of the treatment of uncomplicated malaria cases in Bangui, an area with multidrug-resistant parasites, at a time preceding implementation of a new therapeutic policy relying on the artemisinin derivative combined treatment artemether-lumefantrine. A cross-sectional study was carried out in Bangui city to assess availability of antimalarial drugs and the performances of health workers in the management of uncomplicated malaria. Availability of drugs was recorded in all drugs wholesalers (n=3), all pharmacies in health facilities (n=14), private drugstores (n=15), and in 60 non-official drug shops randomly chosen in the city. Despite a limited efficacy at the time of the survey, chloroquine remained widely available in the official and nonofficial markets. Artemisinin derivatives used in monotherapy or in combination were commonly sold. In health care facilities, 93% of the uncomplicated malaria cases were treated in the absence of any laboratory confirmation and the officially recommended treatment, amodiaquine-sulfadoxine/pyrimethamine, was seldom prescribed. Thus, the national guidelines for the treatment of uncomplicated malaria are not followed by health professionals in Bangui. Its use should be implemented while a control of importation of drug has to be reinforced.
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Seo, Eun Bin, Lissinda H. du Plessis, and Joe M. Viljoen. "Solidification of Self-Emulsifying Drug Delivery Systems as a Novel Approach to the Management of Uncomplicated Malaria." Pharmaceuticals 15, no. 2 (2022): 120. http://dx.doi.org/10.3390/ph15020120.
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Malaria affects millions of people annually, especially in third-world countries. The mainstay of treatment is oral anti-malarial drugs and vaccination. An increase in resistant strains of malaria parasites to most of the current anti-malarial drugs adds to the global burden. Moreover, existing and new anti-malarial drugs are hampered by significantly poor aqueous solubility and low permeability, resulting in low oral bioavailability and patient noncompliance. Lipid formulations are commonly used to increase solubility and efficacy and decrease toxicity. The present review discusses the findings from studies focusing on specialised oral lipophilic drug delivery systems, including self-emulsifying drug delivery systems (SEDDSs). SEDDSs facilitate the spontaneous formation of liquid emulsions that effectively solubilise the incorporated drugs into the gastrointestinal tract and thereby improve the absorption of poorly-soluble anti-malaria drugs. However, traditional SEDDSs are normally in liquid dosage forms, which are delivered orally to the site of absorption, and are hampered by poor stability. This paper discusses novel solidification techniques that can easily and economically be up-scaled due to already existing industrial equipment that could be utilised. This method could, furthermore, improve product stability and patient compliance. The possible impact that solid oral SEDDSs can play in the fight against malaria is highlighted.
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Hempel, Casper, Poul Hyttel, and Jørgen AL Kurtzhals. "Endothelial Glycocalyx on Brain Endothelial Cells is Lost in Experimental Cerebral Malaria." Journal of Cerebral Blood Flow & Metabolism 34, no. 7 (2014): 1107–10. http://dx.doi.org/10.1038/jcbfm.2014.79.
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We hypothesized that the glycocalyx, which is important for endothelial integrity, is lost in severe malaria. C57BL/6 mice were infected with Plasmodium berghei ANKA, resulting in cerebral malaria, or P. chabaudi AS, resulting in uncomplicated malaria. We visualized the glycocalyx with transmission electron microscopy and measured circulating glycosaminoglycans by dot blot and ELISA. The glycocalyx was degraded in brain vasculature in cerebral and to a lesser degree uncomplicated malaria. It was affected on both intact and apoptotic endothelial cells. Circulating glycosaminoglycan levels suggested that glycocalyx disruption preceded cerebral manifestations. The contribution of this loss to pathogenesis should be studied further.
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R., Sandeep B., M. G. Bhutto, and Suresh Babu K. P. "Study of serum cortisol levels in complicated and uncomplicated Plasmodium vivax malaria patients." International Journal of Research in Medical Sciences 9, no. 1 (2020): 254. http://dx.doi.org/10.18203/2320-6012.ijrms20205853.
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Background: Malaria results in pathological changes in various body organs, as the parasite invade and multiply in circulating red blood cells. Despite of advances in diagnostic and treatment modalities, worldwide incidences of malaria are significant. Current study was conducted to investigate serum cortisol level changes as a promising biomarker for risk prediction in malaria and to study adrenal insufficiency in malaria patients.Methods: Current investigation was a prospective observational study, conducted on complicated and uncomplicated Plasmodium vivax malaria patients. Serum cortisol levels in patients were investigated through immunoassay using direct chemiluminescent technology and were statistically correlated with Plasmodium vivax malaria infection.Results: Results of present investigation revealed that on day 1 there was significant difference in mean serum cortisol levels between the Plasmodium vivax malaria patients and control group and cortisol levels were significantly higher in complicated Plasmodium vivax malaria patients compared to uncomplicated cases on day 1 and 7. Cortisol levels were observed to be normal on day 1 and 7 in uncomplicated malaria cases and in patients with bleeding manifestations, renal failure and jaundice. In 10 out of 15 cases of cerebral malaria, significant increase in serum cortisol levels were observed on day 1, while on day 7 levels were normal in all 15 cases.Conclusions: Rise in serum cortisol level had a positive correlation with temperature and thus can be useful to predict the severity of disease in Plasmodium vivax malaria patients. No cortisol insufficiency was observed in during active and convalescent stages of illness.
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Rampengan, Novie H., Jane Metusala, Ronald Chandra, and Praevilia Salendu. "Artesunate-amodiaquine versus artesunatesulfadoxine- pyrimethamine for uncomplicated falciparum malaria in children." Paediatrica Indonesiana 54, no. 1 (2014): 46. http://dx.doi.org/10.14238/pi54.1.2014.46-51.
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Background Malaria is a major cause of morbidity and mortalityin children, especially in developing countries. Art emisinincombination therapy (ACT) has higher rates of parasite clearanceand inhibition of anti-malarial drugs resistance than non-ACT.Hence, we compared the efficacies of artesunate-amodiaquine(AS-AQ) versus artesunate-sulfadoxine pyrimethamine (AS-SP)combination therapies in children with uncomplicated falciparummalaria.Objective To compare the fever clearance time, parasite clearancetime, and length of hospital stay in uncomplicated falciparummalaria patients treated with AS-AQ and AS-SP.Methods We reviewed the medical records of children aged 1- 14years with uncomplicated falciparum malaria admitted to Prof.Dr. R. D. Kandou Hospital between January 2002 - June 2010.Treatment efficacy was evaluated by fever clearance time, parasiteclearan ce time, and length of hospital stay. The differencesof treatment efficacy between the two groups of therapy werean alyzed by independent T test.Results We identified 185 children with uncomplicatedfalciparum malaria, 104 cases were treated with AS-AQ whilethe other 81 received AS-SP. Parasite clearance time was shorterin AS-AQ group than in AS-SP group at 1.38 (SD 0.69) versus1.91 (SD 0.93) days, respectively (95%CI of differences 0.3 0 to0. 76, P<0.05) . The length of hospital stay was shorterin AS-AQgroup than in the AS-SP group, at 5.01 (SD 1.22) versus 6.04(SD 0.98) days, respectively (95%CI of differences 0. 71 to 1.35,P < 0.05). However, there was no statistically significant differencein fever clearance time between the groups.Conclusion AS-AQ combination therapy reduces parasiteclearance time and length of hospital stay compared to AS-SP46 • Paediatrlndones, Vol. 54, No. 1, January 2014combination therapy in children with uncomplicated falciparummalaria.
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Lyke, K. E., R. Burges, Y. Cissoko та ін. "Serum Levels of the Proinflammatory Cytokines Interleukin-1 Beta (IL-1β), IL-6, IL-8, IL-10, Tumor Necrosis Factor Alpha, and IL-12(p70) in Malian Children with Severe Plasmodium falciparum Malaria and Matched Uncomplicated Malaria or Healthy Controls". Infection and Immunity 72, № 10 (2004): 5630–37. http://dx.doi.org/10.1128/iai.72.10.5630-5637.2004.
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ABSTRACT Inflammatory cytokines play an important role in human immune responses to malarial disease. However, the role of these mediators in disease pathogenesis, and the relationship between host protection and injury remains unclear. A total of 248 cases of severe Plasmodium falciparum malaria among children aged 3 months to 14 years residing in Bandiagara, Mali, were matched to cases of uncomplicated malaria and healthy controls. Using modified World Health Organization criteria for defining severe malaria, we identified 100 cases of cerebral malaria (coma, seizure, and obtundation), 17 cases of severe anemia (hemoglobin, <5 g/dl), 18 cases combined cerebral malaria with severe anemia, and 92 cases with hyperparasitemia (asexual trophozoites, >500,000/mm3). Significantly elevated levels (given as geometric mean concentrations in picograms/milliliter) of interleukin-6 (IL-6; 485.2 versus 54.1; P = <0.001), IL-10 (1,099.3 versus 14.1; P = <0.001), tumor necrosis factor alpha (10.1 versus 7.7; P = <0.001), and IL-12(p70) (48.9 versus 31.3; P = 0.004) in serum were found in severe cases versus healthy controls. Significantly elevated levels of IL-6 (485.2 versus 141.0; P = <0.001) and IL-10 (1,099.3 versus 133.9; P = <0.001) were seen in severe malaria cases versus uncomplicated malaria controls. Cerebral malaria was associated with significantly elevated levels of IL-6 (754.5 versus 311.4; P = <0.001) and IL-10 (1,405.6 versus 868.6; P = 0.006) compared to severe malaria cases without cerebral manifestations. Conversely, lower levels of IL-6 (199.2 versus 487.6; P = 0.03) and IL-10 (391.1 versus 1,160.9; P = 0.002) were noted in children with severe anemia compared to severe malaria cases with hemoglobin at >5 g/dl. Hyperparasitemia was associated with significantly lower levels of IL-6 (336.6 versus 602.1; P = 0.002). These results illustrate the complex relationships between inflammatory cytokines and disease in P. falciparum malaria.
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Nosten, Francois Henri. "Pyronaridine-artesunate for uncomplicated falciparum malaria." Lancet 375, no. 9724 (2010): 1413–14. http://dx.doi.org/10.1016/s0140-6736(10)60582-x.
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Omar, S., and D. C. Warhurst. "Treatment of uncomplicated malaria: A reply." Transactions of the Royal Society of Tropical Medicine and Hygiene 96, no. 5 (2002): 573. http://dx.doi.org/10.1016/s0035-9203(02)90448-7.
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A. Ali, Elrazi, Tajeldin M. Abdalla, and Ishag Adam. "Platelet distribution width, mean platelet volume and haematological parameters in patients with uncomplicated plasmodium falciparum and P. vivax malaria." F1000Research 6 (June 12, 2017): 865. http://dx.doi.org/10.12688/f1000research.11767.1.
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Background: The association between the haematological profile (including abnormal platelets) and malaria is not completely understood. There are few published data on haematological profiles of malaria patients in areas with unstable malaria transmission. The current study was conducted to investigate if the haematological parameters, including platelet indices, were reliable predictors for microscopically-diagnosed malaria infection. Methods: A case-control study with a total of 324 participants (162 in each arm) was conducted at the out-patient clinic of New Halfa hospital during the rainy and post rainy season (August 2014 through to January 2015). The cases were patients with uncomplicated Plasmodium falciparum (107; 66.9%) and P. vivax malaria (55, 34.0%) infections. The controls were aparasitemic individuals. The haematological parameters were investigated using an automated hemo-analyser. Results: There was no significant difference in the mean (±SD) age between the study groups; however, compared to the controls, patients with uncomplicated malaria had significantly lower haemoglobin, leucocyte and platelet counts, and significantly higher red cell distribution width (RDW), platelet distribution width (PDW) and mean platelet volume (MPV). Conclusions: The study revealed that among the haematological indices, PDW and MPV were the main predictors for uncomplicated P. falciparum and P. vivax malaria infection. Abbreviations: OR: odds ratio.
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Jegede, Ayodele S., Ikeoluwapo O. Ajayi, Frederick O. Oshiname, Catherine O. Falade, and al. et. "Qualitative assessment of rural health workers' management of malaria in sick children." MalariaWorld Journal 6, no. 7 (2015): 1–10. https://doi.org/10.5281/zenodo.10870159.
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<strong>Background.</strong> Febrile illnesses are common causes of morbidity and mortality among under-five children in sub-Saharan Africa. The recommended strategy for effective case management of uncomplicated malaria is parasitological confirmation prior to use of artemisinin-based combination therapy (ACT). There is a lack of qualitative information explaining factors, which influence malaria case management practices among health workers. This study explores the perceptions of health managers and health care providers on the case management of uncomplicated malaria among under-fives in selected primary health care (PHC) facilities of two Local Government Areas (LGAs), Katcha and Gbako, as part of baselines for capacity-building interventions planned in Niger State, Nigeria. <strong>Methods.</strong> Interviewees included state- and LGA-level health programme managers, and frontline health workers purposively selected to cover a range of cadres involved in case management of sick children. Issues explored were history taking, diagnosis, appropriate diagnosis of malaria, prescription for malaria, referrals and adherence to referral. Data coding was carried out with Nvivo qualitative software (version 8) and content analysed. <strong>Results.</strong> History taking was often not carried out appropriately by the health workers. Treatment of malaria was not based on parasite-based diagnosis. Most of the health workers reported that they prescribed ACTs for treating presumed uncomplicated malaria. Care givers’ preferences, poor transportation systems and lack of financial resources led to poor adherence to referral advice. Absence of health workers from their duty post hindered effective service delivery. Prescription of ACTs as a first line of treatment for uncomplicated malaria without a parasite-based diagnosis was the standard case management practice. <strong>Conclusion.</strong> Parasite-based diagnosis for malaria will invariably lead to better treatment for non-malaria fever cases among the studied age group. Continuous capacity building aimed at improving adherence to current recommendations on parasitebased diagnosis and good clinical practice would be required to support the paradigm shift to parasite-based diagnosis of malaria.
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Samad, R., MR Rahman, EB Yunus, et al. "An open randomized controlled trial to compare the efficacy of two fixed dose combinations of artemesinin based combinations for uncomplicated falciparum malaria in Bangladesh." Bangladesh Medical Research Council Bulletin 39, no. 3 (2014): 109–15. http://dx.doi.org/10.3329/bmrcb.v39i3.20310.
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National Malaria Control Program (NMCP) of Bangladesh has introduced Artemisinin Based Combination (ACT), Coartem(R) (Artemether-Lumefantrine (AL), fixed dose combination, in the confirmed cases of uncomplicated P. falciparum malaria since 2004. Despite the reduction of mortality due to malaria, the development and spread of anti-malarial drug resistance wordwide posing a threat to the health services and will make it difficult to control malaria in Bangladesh in future. We need to have an alternative to Coartem which could be Artesunate-amodiaquine (AA) in a fixed dose combination (FDC), a cheaper altenative not yet evidenced to be effective and safe to our population. In this study we compared the efficacy and safety of Artemether + Lumefantrene (FDC, Coartem®) with Artesunate +Amodiaquine tablets (100/270 mg FDC) for the treatment of uncomplicated P. falciparum malaria in three high risk multi-drug resistant malaria prevalent areas of Bangladesh. It was an open label randomized controlled trial conducted between December 2008 and November 2009 in 4 upazillas in patients over the age 12 to 60 years diagnosed as a case of uncomplicated P.falciparum malaria. The outcome of the cases were measured as clinical response, parasitological response, defervescence time and parasite clearance time. Drug safety was assessed by comparing the adverse events. A total of 252 cases were randomized to receive Artesunate + Amodiaquine (AA group, 147 cases) and Artemether + Lumefantrene (AL group, 106 cases), one lost to follow up at day 28 in AA group. The distribution of the cases was comparable by age, sex and study sites. Treatment success response was observed 100% in the AL group and AA group had 99%, two failures with AA were late treatment failures and the difference was not statistically significant (p>.1). The parasitological sensitive (S) response was observed in 97% of cases in AL group and 95% in the AA group, and was not a statistically significant difference. There was no significant difference in deffervescence time and parasite clearance time between two groups of cases. No serious adverse events were observed. The frequencies of minor adverse events were insignificantly different between the two treatment groups. The two ACT regimen, AA and AL had no significant difference in efficacy and safety for treatment of Uncomplicated Malaria in Bangladesh. However, there were few more failures with AA regimen compared to AL regimen, which was not statistically significant. Both these regimens can be used alternatively by the NMCP of Bangladesh as first-line treatment option. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20310 Bangladesh Med Res Counc Bull 2013; 39: 109-115
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Kumar, Ch Subhash, D. Prashanth, D. Sharath Kumar, and M. Harikrishna Reddy. "A study of clinical profile and outcome of malaria in adults at government general hospital, Nizamabad." Panacea Journal of Medical Sciences 12, no. 2 (2022): 380–86. http://dx.doi.org/10.18231/j.pjms.2022.072.
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What has to be stressed is the need to be cautious with such individuals and to broaden our differentials to include P. vivax as a possible cause of severe malaria. Patients who are aggressively handled and treated can have a better outcome.To study the clinical profile and outcome of malaria in adults at Government General Hospital in our local area. A Cross-sectional, observational study done in Department of general medicine in Fifty smear positive malaria patients admitted to the medical wards and intensive care units are included in the study. Study done for a period of 1 Year . Patients of either gender, above 18 years of age and below 60 years of age, diagnosed with malaria on peripheral smear were included in study.: A total number of 50 smear positive malaria patients were included in the study. Majority of the patients belongs to the age group of 18-30 years [36%] CNS findings: Altered Sensorium was seen in 20% patients and convulsions were seen in 20% patients. Complicated malaria was present in 76% patients and uncomplicated malaria was present in 24% patients. Complicated falciparum malaria was present in 30% patients and Complicated Vivax malaria was present in 46% patients. Uncomplicated falciparum malaria was present in 4% patients and Uncomplicated Vivax malaria was present in 20% patients. Mortality was seen in 6% patients. Mortality was seen in the age group of 41- 50 years [66.7%] and 31-40 years [33.3%]. : Malaria complications can be reduced by studying the clinical profile of the disease and using proper antimalarial medication treatment. This aids in the reduction of malaria morbidity and death, as well as the country's long-term economic prosperity.
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Ugwu, Angela Ogechukwu. "Relationship between Neutrophil-lymphocyte Ratio, Monocyte-Lymphocyte Ratio and Parasitaemia in Determining the Severity of Malaria Infection in Children." Trop J Med Res 22, no. 2 (2024): 23–32. https://doi.org/10.5281/zenodo.14498883.
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<strong>Abstract</strong> <strong>Background</strong>: Malaria often presents as a febrile illness which causes noticeable changes in the haematological parameters. There were inconsistencies with the report on the relationship between the haematological parameters and level of parasitaemia. <strong>Objectives</strong>: This study therefore aimed to ascertain the correlation between the level of parasites in the blood, the neutrophil-lymphocyte ratio (NLR) and the monocyte –lymphocyte ratio (MLR) as a measure of severity of malaria infection. <strong>Materials and Methods</strong>: This was a cross-sectional study involving three groups of children: complicated malaria, uncomplicated malaria and healthy controls. Haematological profile was done using a haematology auto-analyzer. Parasite density was done using microscopy. The study's data was analyzed utilizing the Statistical product and services solutions (SPSS) version 25. <strong>Results</strong>: The mean level of NLR and MLR was higher in children with complicated than uncomplicated malaria (p = 0.023); and normal healthy children (p < 0.001). About half 46.3% of the children in the complicated group had parasitaemia in the range of >100-5000 parasites /µL while 47.5% of children in the uncomplicated group had parasitaemia in the range of 500-1000 parasites /µL. The mean parasite density for complicated and uncomplicated groups were 4542.9 and 1666.6/ µL respectively. A positive significant correlation was seen between NLR, MLR and the parasite density in the complicated malaria group {r= 0.623, P=0.022). <strong>Conclusion</strong>: The NLR and MLR correlate positively with the level of parasitaemia. Consequently, these ratios could serve as a surrogate for the level of parasitaemia and hence the severity of malaria in children.
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Akinkunmi, B. F., O. O. Ogunkunle, F. O. Akinbami, and A. E. Orimadegun. "Electrocardiographic features in children with severe falciparum malaria at the University College Hospital, Ibadan." Research Journal of Health Sciences 10, no. 3 (2022): 198–206. http://dx.doi.org/10.4314/rejhs.v10i3.4.
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Introduction: The high burden of Malaria morbidity and mortality in children is due to its potential to cause multi-organ dysfunction. There is however limited information on the specific electrocardiographic features in falciparum malaria in paediatric age group.Aim: To investigate the electrocardiographic (ECG) features in children with (complicated) severe falciparum malaria (SM) and acute uncomplicated malaria (AUM) at the University College Hospital, Ibadan.Methods: This was a comparative cross-sectional study conducted among 398 children with symptomatic and confirmed Plasmodium falciparum malaria and apparently healthy controls. The frequencies of ECG features were described and compared among these children.Results: The prevalence of ECG abnormality was 79.7% and 63.2% in Severe Malaria SM and Acute uncomplicated malaria AUM patients, respectively. Sinus tachycardia was significantly more frequent in SM than AUM and control groups (p <0.001). The risk of an ECG abnormality was about three times higher in SM than healthy children (p<0.001; OR=2.89;95%CI[1.68,4.99).Conclusion: Severe malaria patients had significant ECG abnormalities (Sinus Tachycardia).
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A., Sivaraman, Venkataraman Surendran, R. Balasubramanian, N. Kavitha, Jain Dhiraj, and Kumhar Maniram. "Serum Cortisol Level as a Predictive Biomarker of Severity of Disease among Adult Plasmodium Vivax Patients in Northern India." International Journal of Pharmaceutical and Clinical Research 15, no. 7 (2023): 1195–201. https://doi.org/10.5281/zenodo.11857003.
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<strong>Background: </strong>Malaria is a major cause of morbidity in Indian subcontinent accounting for approximately 88% of malaria cases in the Southeast Asia. The disease affects all organs and endocrine glands are no exception. Serum cortisol, a hormone released by adrenal gland has the potential to serve as a predictive biomarker for mortality and critical illness among malaria patients. <strong>Aim:</strong> This study aimed to investigate changes in serum cortisol levels as a potential biomarker for predicting risk in P. vivax malaria. <strong>Methods:</strong> The study was a prospective observational investigation from September 2017 to October 2018. The study involved 40 patients each with complicated, uncomplicated Plasmodium vivax malaria patients and compared with healthy controls. Serum cortisol levels were measured using immunoassay with direct chemiluminescent technology and statistically correlated with Plasmodium vivax malaria infection. <strong>Results:</strong> The results revealed that on day 1, there was a significant difference in mean serum cortisol levels between Plasmodium vivax malaria patients and the control group. Cortisol levels were significantly higher in patients with complicated Plasmodium vivax malaria compared to uncomplicated cases on both day 1 and day 7. Cortisol levels remained within the normal range on days 1 and 7 in uncomplicated malaria cases. The optimum cut-off for cortisol level to predict severity of malaria was 18.6 ug/dl for a sensitivity of 88.5% and specificity of 85.8%. <strong>Conclusions: </strong>The serum cortisol levels were significantly higher among complicated malaria patients and hence could be a useful indicator for predicting the severity of Plasmodium vivax malaria.
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Salih, Magdi M., Hatim G. Eltahir, Tajeldin M. Abdallah, et al. "Haematological parameters, haemozoin-containing leukocytes in Sudanese children with severe Plasmodium falciparum malaria." Journal of Infection in Developing Countries 12, no. 04 (2018): 273–78. http://dx.doi.org/10.3855/jidc.9906.
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Introduction: Haemozoin –containing leucocytes (HCL) can be used to predict severe malaria.
 Methodology: A case –control study was conducted in Singa, Sudan, to investigate the haematological values and HCL in children with severe Plasmodium falciparum malaria. The cases were children with severe P. falciparum malaria (67). The two groups of controls were patients with uncomplicated P. falciparum malaria (63) and healthy children (50).
 Results: The mean (±SD) age was 5.5 (±3.8) years. In comparison with children with uncomplicated P. falciparum malaria, children with severe P. falciparum malaria had significantly lower haemoglobin and platelet counts, and significantly higher lymphocyte counts, red cell distribution width (RDW), and platelet distribution width (PDW). The rate of haemozoin –containing monocytes (percentage of children positive for this parameter in each group) was 91.0%, 84.6% and 50.0%, P<0.001 in children with severe P. falciparum, uncomplicated P. falciparum malaria and negative controls, respectively. Receiver Operating Characteristic (ROC) curves for blood parameters and HCL were plotted and the areas under the curve (AUC) were calculated for the prediction of severe P. falciparum malaria infection. The ROC curve analysis, showed a fair predictability of malaria for haemoglobin (AUC = 0.74, sensitivity = 76.0% and specificity = 60.3%, cut-off = 9.7g/dl), lymphocytes (AUC = 0.71, sensitivity = 71.3% and specificity = 62.2%, cut-off = 1.95×103/mm3), PDW (AUC = 0.69, sensitivity = 80.1% and specificity = 66.3%, cut-off = 15.34 %) and haemozoin in the monocytes (AUC = 0.68, sensitivity = 68.2% and specificity = 65.2%, cut-off =5.5 %).
 Conclusion: RDW, PDW and HCL could be used to predict severe malaria in this setting.