Changes in serum lipid profile in the acute and convalescent Plasmodium vivax malaria: A cohort study.

Although serum lipids are known to be altered in Plasmodium falciparum-induced malaria, little is known about such changes due to Plasmodium vivax infection. This cohort study assessed serum concentrations of triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) in 164 patients in the acute phase of malaria caused by P. vivax and characterized these changes in the convalescent phase after treatment with chloroquine and primaquine. Compared to reference values, serum total cholesterol, LDL, and HDL levels were lower and triglyceride levels were higher in the acute phase. Moreover, the parasite density was negatively correlated with LDL (r=-0,189; p=0.027) and HDL (r=-0,256; p=0.001) serum levels. Eighty patients returned for clinical and laboratory revaluation 7-12days after treatment initiation. All patients showed parasite clearance and the absence of symptoms during the convalescent phase. Analysis of the serum lipids of these 80 patients showed significant increases in the serum levels of total cholesterol (p<0.0001), LDL (p<0.0001), and HDL (p<0.0001) as well as a significant reduction in triglycerides (p=0.004), indicating a trend towards a return to normal levels. This transient change in lipid profile between the acute and convalescent stages may be useful for the clinical monitoring of patients treated for vivax malaria.

[Malaria alertness in the post-elimination period: clinical and laboratory aspects].

Early detection of imported cases of malaria and its prompt and efficacious treatment are one of the main tasks of health workers in malaria prevention during the post-elimination period. The diagnosis and treatment of malaria should be developed and standardized to prevent the re-emergence of local transmission from imported cases of malaria. Its diagnosis must be verified by only laboratory tests during the post-elimination period. Keeping in mind the possible rapid conversion of uncomplicated P. falciparum malaria into a several disease, these all cases should be managed in a hospital setting. The healthcare personnel dealing with the treatment of malaria should be aware of its clinical manifestations in non-immune residents and semi-immune immigrants. The main principles of malaria treatment are discussed in respect of age, sex, pregnancy, and different malaria species.