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1.
Journal of Infection and Public Health. 2013; 6 (1): 10-15
in English | IMEMR | ID: emr-130297

ABSTRACT

In the majority of health centers in Ethiopia, the severity of falciparum malaria has been determined by parasitemia alone. However, it has been suggested that the use of peripheral infected RBC counts as an indicator of disease severity by itself is insufficient. Therefore, this study was performed to assess the severity of falciparum malaria infection in three Ethiopian localities with epidemic malaria and to compare the usual severe malaria determination technique [parasitemia] used in Ethiopia with other malaria severity determination parameters: circulatory collapse, cerebral malaria and severe anemia. Blood samples were collected from 400 individuals to examine the presence of falciparum malaria in the Awash, Metehara and Ziway areas of Ethiopia. Data on cerebral malaria, circulatory collapse and severe anemia were collected from 210 falciparum malaria patients. Of the 400 individuals examined, 210 were positive for falciparum malaria, and 190 were negative and served as healthy controls [HC]. Severe anemia [18 patients, 8.57%] and circulatory collapse [25 patients, 11.90%] were the common features associated with severe falciparum malaria. Additionally, the detection of severe malaria was comparable using parasitemia, circulatory collapse or anemia. The findings of this study demonstrated comparable capacity for detecting severe falciparum malaria using circulatory collapse, severe anemia or parasitemia. Therefore, in addition to parasitemia, assessing severity of falciparum malaria using circulatory collapse and severe anemia will facilitate the diagnosis and management of malaria in Ethiopia


Subject(s)
Humans , Female , Male , Malaria, Falciparum/diagnosis , Plasmodium falciparum , Severity of Illness Index , Malaria, Falciparum/therapy
2.
Article in English | IMSEAR | ID: sea-157339

ABSTRACT

Cardiac functions are almost well preserved in malarial infection. We report a rare case with fatal complication of myocardial infarction in patient with delayed diagnosis of Plasmodium falciparum infection. The authors therefore, suggest that every case of fever especially if associated with risk factor for cardiovascular disease should be immediately investigated for malaria so as to prevent this grave complication. This is even more important for people living in malarial endemic areas.


Subject(s)
Humans , Malaria, Falciparum/complications , Malaria, Falciparum/therapy , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Infarction/therapy , Plasmodium falciparum/pathogenicity
3.
Journal of the Egyptian Society of Parasitology. 2011; 41 (3): 573-592
in English | IMEMR | ID: emr-117269

ABSTRACT

Malaria still tops the prevalent human arthropod-borne diseases. In Egypt, sporadic cases of human malaria were reported with a focus in Al-Fayoum. Besides, many Egyptian Anopheles species were reported allover which are either malaria vectors or incriminated ones. This study recorded An. multicolor, An. sergentii, and An. algeriensis in Toshka. Many authors reported that A. sergentii is a malaria-vector and A. multicolor is a suspected vector. Consquently, the endemicity of Chloroquine resistant Plasmodium falciparum on the Egyptian-Sudanese border pave the way for malignant malaria transmission particularly among travelers returning back from Sudan


Subject(s)
Insecta , Malaria/transmission , Plasmodium falciparum , Malaria, Falciparum/therapy , Chloroquine , Drug Resistance
4.
Rev. bras. ginecol. obstet ; 32(12): 579-583, dez. 2010. tab
Article in Portuguese | LILACS | ID: lil-581580

ABSTRACT

OBJETIVO: analisar a evolução clínica de três pacientes grávidas com malária grave internadas em unidade de terapia intensiva de um hospital localizado em Porto Velho (RO). MÉTODOS: foi realizado estudo descritivo em três gestantes, portadoras de malária por Plasmodium falciparum, internadas em unidade de terapia intensiva em Porto Velho, no período de 2005 a 2006. As variáveis categóricas utilizadas foram os critérios de classificação da Organização Mundial de Saúde para classificação de malária grave e os índices Acute Physiology and Chronic Health disease Classification System II (APACHE II) e Sepsis Related Organ Failure Assessment (SOFA) preditores de morbidade e gravidade das doenças em unidade de terapia intensiva. RESULTADOS: a malária adquirida pelas gestantes, caracterizada pela infecção por Plasmodium falciparum na forma grave da doença, resultou em óbito para as três pacientes e seus conceptos. CONCLUSÕES: embora a casuística seja pequena, a importância deste estudo reflete a repercussão da malária grave em gestantes, bem como a necessidade de um acompanhamento pré-natal mais criterioso e atento à identificação precoce do início das complicações da malária em gestantes.


PURPOSE: to analyze the clinical course of three pregnant patients with severe malaria admitted to the intensive care unit of a hospital in Porto Velho (RO), Brazil. METHODS: a descriptive study was conducted on three pregnant women infected with Plasmodium falciparum malaria, admitted to the intensive care unit of a hospital in Porto Velho from 2005 to 2006. Categorical variables used were the classification criteria of the World Health Organization which ranks severe malaria and the Acute Physiology and Chronic Health Disease Classification System II (APACHE II) and Sepsis Related Organ Failure Assessment (SOFA) predictors of morbidity and severity of intensive care unit diseases. RESULTS: the malaria acquired by the pregnant subjects characterized by infection with Plasmodium falciparum in its most serious form resulted in death for all three patients and their fetuses. CONCLUSIONS: although the sample of this study was small it reflects the important impact of severe malaria on pregnant women as well as the need for a more judicious and attentive prenatal care to identify the disease in its early stages and its first complications in pregnant women.


Subject(s)
Adolescent , Adult , Female , Humans , Pregnancy , Young Adult , Malaria, Falciparum , Pregnancy Complications, Parasitic , Malaria, Falciparum/diagnosis , Malaria, Falciparum/therapy , Pregnancy Complications, Parasitic/diagnosis , Pregnancy Complications, Parasitic/therapy , Retrospective Studies , Severity of Illness Index
5.
Article in English | IMSEAR | ID: sea-89009

ABSTRACT

Red cell exchange using a cell separator (therapeutic erythrocytapheresis) has been used successfully in a large number of clinical conditions including acute severe cases of malaria. We report two children suffering from severe malaria (Plasmodium falciparum) with infestation rates of 75% and 67% respectively. They were treated successfully with erythrocytapheresis in combination with antimalarial treatment.


Subject(s)
Antimalarials/therapeutic use , Artemisinins/therapeutic use , Child , Erythrocyte Transfusion , Humans , Malaria, Falciparum/therapy , Male , Platelet Count , Sesquiterpenes/therapeutic use
9.
Article in English | IMSEAR | ID: sea-44219

ABSTRACT

We set up a simple extracorporeal circuit, modified from the extracorporeal method generally used in conventional hemodialysis, for exchange transfusion. Temporary vascular access was used in exchange transfusion for both draining the infected blood and infusion of the freshly non-infected blood. This method of exchange transfusion was performed in 3 severe complicated falciparum malaria patients who had a percentage of parasitemia of 80, 40, and 35. The magnitude of parasitemia decreased immediately to less than one per cent and this value persisted twenty-four hours after the procedure. No complications of exchange transfusion were detected in all patients. Erythrocyte morphology determined by scanning electron microscopy was unaltered by exchange transfusion. Because of the simplicity, the effectiveness, and the safety of the procedure, this extracorporeal circuit modified from hemodialysis circuit would be a more beneficial exchange transfusion method in the treatment of severe complicated falciparum malaria than the manually-performed one.


Subject(s)
Adult , Exchange Transfusion, Whole Blood/methods , Female , Humans , Malaria, Falciparum/therapy , Male , Middle Aged , Renal Dialysis
10.
Bol. Soc. Peru. Med. Interna ; 13(1): 30-9, 2000. ilus, tab
Article in Spanish | LILACS | ID: lil-267273

ABSTRACT

Se realizó el estudio descriptivo, prospectivo y transversal de 186 pacientes que presentaron malaria grave y complicada por P. falciparum en la Unidad de Cuidados Intensivos del Hospital Regional de Loreto (Iquitos). Se hospitalizaron casos de malaria grave y complicaciones desde junio de 1996 hasta mayo de 1999. Procediendo el mayor número de casos del Río Nanay y de la zona urbana marginal de Iquitos, la edad más afectada fue la comprendida entre los 15 a 39 años de edad, predominando el sexo femenino en el 58.1 por ciento, las estancias hospitalarias en la Unidad de Cuidados Intensivos fue de 3 a 5 días en la mayoría de los casos. El cuadro clínico predominante fue malestar, cefalea, fiebre, escalofríos. La Gota Gruesa fue positiva a P. falciparum en el 93.01 por ciento de los casos. Se utilizó quinina endovenoso de inicio en el 97.3 por ciento de los casos, continuándose con la combinación quinina tetracilina. Las complicaciones más frecuentes encontradas fueron: anemia severa (41.9 por ciento), malaria cerebral (25.3 por ciento) e hipoglicemia y RAM (22.6 por ciento c/u). La mortalidad encontrada fue de 8.1 por ciento, siendo la causa más frecuente, la insuficiencia renal aguda.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Malaria, Falciparum/complications , Malaria, Falciparum/therapy , Cross-Sectional Studies , Epidemiology, Descriptive , Prospective Studies
11.
Article in English | IMSEAR | ID: sea-43121

ABSTRACT

Malaria associated with complications or a fatal outcome is caused by Plasmodium falciparum. The mortality due to this disease is parallel to the degree of parasitemia. Successful use of exchange blood transfusion as a therapeutic adjunct for this infection was reported. The rationale for this form of therapy is based on (1) rapid reduction in parasite load by exchange transfusion, (2) removal of toxic substances and (3) reducing microcirculatory sludging. We describe here thirteen cases of severe falciparum malaria treated with infusion of quinine dihydrochloride and exchange transfusion 2,320-8,000 ml of whole blood. We observed that the greatest reduction in the average circulating infected red blood cells, from 20.7 per cent to 9.3 per cent, seemed to occur early in the first 2,000 ml of blood exchange and the parasitemia often reduced to 5.1 per cent in patients who had 4,000 ml of blood exchange. In order to reduce the initial parasitemia to 5 per cent by exchange transfusion, we suggest the volume of exchange transfusion should be 2,000 ml for average parasitemia 10 per cent, 4,000 ml for parasitemia > 20 per cent and 2,000-4,000 ml for parasitemia 10-20 per cent.


Subject(s)
Adult , Antimalarials/therapeutic use , Exchange Transfusion, Whole Blood , Female , Humans , Malaria, Falciparum/therapy , Male , Middle Aged , Quinine/therapeutic use
14.
Antibiot. infecc ; 5(3/4): 29-32, jul.-dic. 1997.
Article in Spanish | LILACS | ID: lil-252031

ABSTRACT

Las enfermedades parasitarias se pueden presentar como emergencias médicas, en los países tropicales y subdesarrollados. La actualización permanente de su manejo clínico-terapéutico se puede realizar mediante la descripción de casos representativos. Se describen seis pacientes atendidos como emergencias: un electricista con absceso hepático amibiano que drenó a pleura, una hiperinfección por Strongyloides stercoralis, una recaida por leishmaniasis visceral, una niña con leishmaniasis de la mucosa nasal, un minero con insuficiencia renal que adquirió un paludismo por P.facilparum resistente a la cloroquina y un transportista con paludismo por P.vivax resistente a primaquina. Se discuten las complicaciones clínico-terapéuticas de los pacientes y se revisa la literatura médica disponible para actualizar estas parasitosis


Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Adult , Middle Aged , Liver Abscess, Amebic/diagnosis , Liver Abscess, Amebic/therapy , Leishmaniasis, Visceral/diagnosis , Parasitic Diseases/diagnosis , Parasitic Diseases/therapy , Pleura , Strongyloides stercoralis/parasitology , Malaria, Falciparum/complications , Malaria, Falciparum/therapy , Malaria, Vivax/complications , Malaria, Vivax/therapy , Nasal Cavity/parasitology
16.
Rev. patol. trop ; 24(1): 1-9, jan.-jun. 1995. tab
Article in Portuguese | LILACS | ID: lil-176504

ABSTRACT

Falhas no diagónstico e na conduta terapêutica antes da internaçäo foram analisadas em relaçäo a letalidade em 102 pacientes portadores da forma grave da Malária por P. falciparum, segundo critérios da OMS (1990). Diagnóstico coreto foi observado em 62 (60.8) (pôr cento) pacientes, com letalidade de 17.7 (pôr cento) e incorreto em 40 (39.3) (pôr cento), com letalidade de 40(pôr cento) (p=0.01). Conduta terapêutica apropriada foi observada em 21/62 pacientes (33.9) (pôr cento), com letalidade de 9.5 (pôr cento) e inapropriada em 41/62 (66.1) (pôr cento), com letalidade de 21.9(pôr cento) e inapropriada (p> 0.05). Nos pacientes com até 4 dias de doença a letalidade foi de 5.0(pôr cento), nos com 5 a 7 dias, 25.8(pôr cento)e com mais de 7 dias 35.3(pôr cento) (p< 0.05). Os diagnóstico incorretos mais freqüentes foram: Hepatite 30(pôr cento), Infeçäo do trato urinário 25(pôr cento), Malària por P. vivax e febre amarela 15(pôr cento) e Septicemia 7.5(pôr cento). A letalidade foi significativamente maior (p=0.01) naqueles com diagnóstico incorreto e com mais de 4 dias de doença. Os dados mostram um elevado índice de erro no diagnóstico e na conduta terapêutica especíifica na Malária Grave, bem como suas consequências deletérias para os pacientes


Subject(s)
Humans , Malaria, Falciparum/diagnosis , Malaria, Falciparum/therapy , Plasmodium falciparum
17.
Goiânia; s.n; 1984. 130 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: lil-129948

ABSTRACT

Em 100 pacientes com malária por Plasmodium falciparum, 63 tratados com cloroquina (50 a 90 mg/Kg peso, em 3 a 6 dias) e 46 com quinina (1,5 g/dia, durante 7 dias), foram estudadas a cardiotoxicidade e resposta terapêutica dessas drogas. A avaliaçåo da cardiotoxicidade baseou-se em achados clínicos, evoluçåo eletrocardiográfica e determinaçåo dos níveis enzimáticos (transaminase glutâmico-oxalacética e creatinafosfotransferase) antes, durante e após o tratamento. Quanto à cloroquina, a cardiotoxicidade manifestou-se principalmente sobre os mecanismos da repolarizaçåo ventricular (42,8 por cento), embora tenha ocorrido, com muito menor frequência, depressåo da excitabilidade (4,7 por cento), retardo na conduçåo do estímulo elétrico (14,2 por cento), arritmia supraventricular (1,6 por cento) e queda da pressåo arterial (3,2 por cento). Em relaçåo à quinina a depressåo da excitabilidade (bradicardia) foi a manifestaçåo mais significativa (34,7 por cento); foram também detectadas alteraçoes da repolarizaçåo ventricular (15,2 por cento), retardo na conduçåo do estímulo elétrico (19,5 por cento) e queda da pressåo arterial (21,7 por cento). No tacante à resposta terapêutica, nåo houve resistência a nível de RII e RIII, segundo os padroes da Organizaçåo Mundial de Saúde, com quaisquer das drogas. A cloroquina apresentou 15,0 por cento de resistência (RI) e a quinina 2,4 por cento. Ambas as drogas mostraram-se eficazes para o tratamento da doença, sobretudo nas formas graves, nåo tendo havido diferença importante em relaçåo à resposta clínica, apesar da açåo esquizonticida dacloroquina ter se mostrado discretamente mais rápida que a da quinina.


Subject(s)
Chloroquine/adverse effects , Chloroquine/therapeutic use , Chloroquine/toxicity , Malaria, Falciparum/therapy , Quinine/adverse effects , Quinine/therapeutic use , Quinine/toxicity , Heart
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