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Aims:The study aims to estimate the lipid parameters among Plasmodium vivaxand mixed malaria (P.falciparum and P. vivax) infected patients. Study Design:This was a prospective observational and comparative study.Place and Duration of Study:The present study was undertaken in the Departments of Medicine and Biochemistry at A.J. Institute of Medical Sciences and Research (AJIMS), Mangaluru, Karnatakabetween Dec 2017 and May 2018.Methods:It was a prospective observational comparative study. A total of 100 patients (50 P. vivaxand 50 mixed malaria cases) were consecutively taken in the study. The lipid profiles of the cases were compared with that of100 healthy volunteers (control group). Data was collected and analysed. Results:Serum total cholesterol, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) levels were significantly low(p<0.001) in cases and serum Triglycerides (TG) andVery Low-Density Lipoprotein levels (VLDL) were higher in cases (p<0.001) than in control. There were no significant changes in mean serum lipids profiles between P. vivaxand Mixed Malaria groups. Conclusion:The derangement in lipid profiles in falciparum malaria was characteristic and specific for the disease. Characteristic changes were lower HDL, LDL and total cholesterol levels with higher TG and VLDL levels in comparison to control groups. These findings may be of diagnostic and prognostic value.
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Background: Prevalence of complications in malaria continues to grow even with reducing number of malaria cases. Complications associated with malaria can involve multiple organs. There is paucity of literature on factors associated with multi organ dysfunction in different types of malaria.Methods: Our aim was to study the clinical profile of complications in different types of malaria with specific focus on multi-organ dysfunction (MODS). In this cross-sectional study confirmed cases of malaria were enrolled.Results: Plasmodium vivax malaria was the predominant type seen in 74.1% cases. The overall prevalence of thrombocytopenia was 61.5%, hepatic dysfunction 58%, cerebral malaria 16.1%, Hypoglycemia 7.5%, bleeding 34.5%, acute respiratory distress syndrome (ARDS) 5.7% and acute kidney injury (AKI) 49.4%. Hypoglycemia was significantly higher in mixed malaria (0.025, p = 0.025). Hepatic dysfunction and hyperbilirubinemia were significantly higher in mixed malaria (p=0.001). Mortality was seen in mixed malaria (p = 0.007). Only those with mixed malaria died (13%). Patients with MODS had higher prevalence of rashes (p <0.0001) and cerebral malaria (p = 0.000). Serum levels of urea, creatinine, Bilirubin, Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) were significantly higher in patients with MODS (p<0.0001 for all variables). On evaluating factors associated with multi-organ dysfunction presence of cerebral malaria [OR: 6.4 (95% CI): 2.4 to 17.4; p<0.0001], type of malaria (Vivax or Falciparum or both) [1.77 (1.03 to 3.03); p=0.0038], and hypoglycemia [4.4 (1.08 to 17.8); p=0.038] were statistically significant on multivariate analysis.Conclusions: The present study demonstrates the factors associated with multi organ dysfunction and its impact on clinical outcome in different types of malaria.
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Antecedentes: se conoce poco sobre la infección plasmodial mixta (IPMx) y la malaria mixta (MMx). Objetivo: revisar y resumir la información sobre la frecuencia de IPMx/MMx en Colombia y América Latina. Metodología: revisión sistemática sobre IPMx/MMx; se consultó en Pubmed y Lilacs con las expresiones ''malaria mixta'' o ''mixed malaria''. Resultados y conclusiones: la información específica recuperada fue escasa, dispersa y difícil de hallar. La IPMx/MMx se subestima con frecuencia relativamente alta al usar microscopía de luz (gota gruesa). Es frecuente la aparición de una especie plasmodial luego del tratamiento exitoso de la infección por otra especie. El comportamiento epidemiológico de la IPMx/MMx es muy variable en función de la intensidad y la estabilidad de la transmisión, la influencia de los ciclos de lluvia, la edad de las personas y la fauna anofelina. En América Latina, con gota gruesa, 0,46% de las infecciones confirmadas fueron IPMx y con reacción en cadena de la polimerasa (PCR) alcanzaron 12,78%. En Colombia, en 2001-2010, la MMx tuvo un aporte promedio de 1,44% sobre el total de casos de paludismo, que representan 1.839 casos/año. Hasta donde conocemos, por primera vez se presentan datos básicos organizados sobre la frecuencia de IPMx/MMx en Colombia y América Latina.
Background: Mixed plasmodial infection (MxPI) and mixed malaria (MxM) are poorly understood. Objective: To review information about MxPI/MxM and to collect and organize Colombian and Latin American data. Methods: Systematic review on MxIP/MxM; the terms 'mixed malaria' or 'malaria mixta' were used for a search in PubMed and Lilacs. Results and conclusions: Information retrieved was scarce, disperse and difficult to find. MxPI/MxM is underestimated by microscopy (thick blood smear). A second plasmodial species is often detected after successful treatment for infection with another. Epidemiological behavior of MxPI/MxM is variable and depends on transmission intensity and stability, rain cycles, age of patients and anopheline fauna. In Latin America, according to the results of thick blood smear, 0.46% of confirmed infections were MxPI, and with PCR, that proportion reached 12.78%. In Colombia, between 2001 and 2010, MxM (1.839 cases per year) represented an average of 1.44% of the total malaria cases. To our knowledge, this is the first report about baseline data on MxPI/MxM in Colombia and Latin America.
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Humanos , Malária , Plasmodium , Prevalência , RevisãoRESUMO
Introducción: los aspectos clínico-epidemiológicos de la infección plasmodial mixta y la malaria mixta se conocen poco; en América es casi nula la información. Objetivo: revisar y resumir la información sobre infección plasmodial y malaria mixta. Metodología: búsqueda de información en Pubmed y Lilacs con diferentes expresiones. Resultados y conclusiones: la información específica recuperada fue escasa, dispersa y difícil de hallar. La infección plasmodial y malaria mixta con frecuencia variable pero relativamente alta, se subestima al usar microscopía de luz. Es frecuente la aparición de una especie plasmodial luego del tratamiento exitoso de la infección por otra especie. Las coinfecciones plasmodiales son mutuamente supresivas, con P. falciparum dominando a P. vivax y este atenuando la gravedad de la infección por P. falciparum. El cuadro clínico y la parasitemia de cada especie en la infección plasmodial y malaria mixta no están suficientemente estudiados y su comportamiento epidemiológico es muy variable en función de la intensidad y la estabilidad de la transmisión, la influencia de los ciclos de lluvia, la edad de las personas y la fauna anofelina. No hay bases suficientes para orientar el tratamiento de la infección plasmodial y malaria mixta, pero se sugiere que debe darse tratamiento simultáneo para las diferentes especies.
Mixed malaria: overviewBackground: clinical and epidemiological aspects of mixed plasmodial infection and mixed malaria are poorly understood; in America this information is almost absent. Objective:review information about mixed plasmodial infection and mixed malaria and collect and organize Colombian data. Methodology: different expressions were used to find information in PubMed and Lilacs. Results and conclusions: information retrieved was little, dispersed and difficult to find. Mixed plasmodial infection and mixed malaria frequency is variable and relatively high but is underestimated by microscopy. New plasmodial species often is detected after successful treatment of other species. Plasmodial coinfections are mutually suppressive; P. falciparumdominating on P. vivax and P. vivax attenuating severity of P. falciparum. Clinical and parasitemia of each species in mixed plasmodial infection and mixed malaria are not sufficiently studied; its epidemiological behavior is very variable and depends on transmission intensity and stability, rain cycles, age of patients and anopheline fauna. There is insufficient basis to guide the mixed plasmodial infection and mixed malaria treatment, but it is suggested a simultaneous treatment of the different species.