Danger signs in the malaria patient
Keywords:
malaria, signs and symptoms, clinical medicine, physical examination, diagnosis
Abstract
Danger signs are clinical indicators of severity and are useful to predict complications or death. In the malaria patient, clinical or parasitological signs can be easily be recognized during the acute phase of the illness that indicate serious complications. Danger signs include neurological change, abnormal breathing pattern, persistent vomiting and diarrhea, jaundice, bleeding, dark urine, delayed capillary refill, intense pallor, hyperpyrexia, hyperparasitemia and schizontemia. Timely recognition of these signs can lead to a decrease in cases with complications and deaths.
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References
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2. Idro R, Bitarakwate E, Tumwesigire S, John CC. Clinical manifestations of severe malaria in the highlands of southwestern Uganda. Am J Trop Med Hyg. 2005;72:561-7.
3. Organización Mundial de la Salud, Organización Panamericana de la Salud. Evaluación de la eficacia terapéutica de los medicamentos para el tratamiento del paludismo por Plasmodium falciparum sin complicaciones en las Américas. Documento OPS/HCP/HCT/113/98. Washington, D.C.: OPS; 1998.
4. World Health Organization. A manual for community health workers. Geneva; World Health Organization; 1996. p. 46.
5. World Health Organization. Integrated management of childhood illness: conclusions. WHO Division of Child Health and Development. Bull World Health Org. 1997;75(Suppl.1):119-28.
6. World Health Organization. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg. 2000;94(Suppl.1):S1-90.
7. Baird JK. Neglect of Plasmodium vivax malaria. Trends Parasitol. 2007;23:533-9.
8. Price L, Planche T, Rayner C, Krishna S. Acute respiratory distress syndrome in Plasmodium vivax malaria: case report and review of the literature. Trans R Soc Trop Med Hyg. 2007;101:655-9.
9. Padilla JC, Piñeros JG. Situación de la malaria en el Pacífico nariñense durante el año 2001. Inf Quinc Epidemiol Nac. 2001;6:269-73.
10. González L, Guzmán M, Carmona J, Lopera T, Blair S. Características clínico-epidemiológicas de 291 pacientes hospitalizados por malaria en Medellín (Colombia). Acta Med Colomb. 2000;25:163-7.
11. Tobón A, Giraldo C, Piñeros J, Arboleda M, Blair S, Carmona J. Epidemiología de la malaria falciparum complicada: estudio de casos y controles en Tumaco y Turbo, Colombia, 2003. Rev Bras Epidemiol. 2006;9:283-96.
12. Ministerio de Salud de Colombia, Grupo de Malaria Universidad de Antioquia, CIDEIM, Instituto Nacional de Salud, OPS. Manual de operaciones de la red de farmacovigilancia en malaria en Colombia. Evaluación in vivo. Buenaventura (Colombia). Bogotá: Ministerio de Salud de Colombia; Grupo de Malaria, Universidad de Antioquia; CIDEIM; Instituto Nacional de Salud; OPS; 2002. p. 32.
13. Bouchaud O. Diagnosis and management of imported malaria. Rev Prat. 2005;55:863-74.
14. Makani J, Matuja W, Liyombo E, Snow RW, Marsh K, Warrell DA. Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description. QJM. 2003;96:355-62.
15. Newton CR, Hien TT, White N. Cerebral malaria. J Neurol Neurosurg Psychiatry. 2000;69:433-41.
16. Anstey NM, Jacups SP, Cain T, Pearson T, Ziesing PJ, Fisher DA, et al. Pulmonary manifestations of uncomplicated falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis. 2002;185:1326-34.
17. Giraldo C, Blair S, Tobón A. Complicaciones pulmonares en malaria. Infectio. 2004;8:279-91
18. English M, Waruiru C, Amukoye E, Murphy S, Crawley J, Mwangi I, et al. Deep breathing in children with severe malaria: indicator of metabolic acidosis and poor outcome. Am J Trop Med Hyg. 1996;55:521-4.
19. Brandts C, Ndjavé M, Graninger W, Kremsner P. Effect of paracetamol on parasite clearance time in malaria. Lancet. 1997;350:704-9.
20. Seoh JY, Khan M, Park SH, Park HK, Shin MH, Ha EH, et al. Serum cytokine profiles in patients with Plasmodium vivax malaria: a comparison between those who presented with and without hyperpyrexia. Am J Trop Med Hyg. 2003;68:102-6.
21. Eiam-Ong S, Sitprija V. Falciparum malaria and the kidney: a model of inflammation. Am J Kidney Dis. 1998;32:361-75.
22. Peres Bota D, Lopes Ferreira F, Melot C, Vincent JL. Body temperature alterations in the critically ill. Intensive Care Med. 2004;30:811-6.
23. Idro R, Karamagi C, Tumwine J. Immediate outcome and prognostic factors for cerebral malaria among children admitted to Mulago Hospital, Uganda. Ann Trop Paediatr. 2004;24:17-24.
24. Popov AF. Algid malaria. Med Parazitol (Mosk). 2005;1:10-2.
25. Ustianowski A, Schwab U, Pasvol G. Case report: severe acute symptomatic hyponatraemia in falciparum malaria. Trans R Soc Trop Med Hyg. 2002;96:647-8.
26. Sasi P, English M, Berkley J, Lowe B, Shebe M, Mwakesi R, et al. Characterization of metabolic acidosis in Kenyan children admitted to hospital for acute non-surgical conditions. Trans R Soc Trop Med Hyg. 2006;100:401-9.
27. Molyneux ME, Looareesuwan S, Menzies IS, Grainger SL, Phillips RE, Wattanagoon Y, et al. Reduced hepatic blood flow and intestinal malabsorption in severe falciparum malaria. Am J Trop Med Hyg. 1989;40:470-6.
28. Reisinger EC, Fritzsche C, Krause R, Krejs GJ. Diarrhea caused by primarily non-gastrointestinal infections. Nat Clin Pract Gastroenterol Hepatol. 2005;2:216-22.
29. Planche T, Onanga M, Schwenk A, Dzeing A, Borrmann S, Faucher JF, et al. Assessment of volume depletion in children with malaria. PLoS Med. 2004;1:56-63.
30. Maitland K, Levin M, English M, Mithwani S, Peshu N, Marsh K, et al. Severe P. falciparum malaria in Kenyan children: evidence for hypovolaemia. QJM. 2003;96:427-34.
31. Gorelick MH, Shaw KN, Baker MD. Effect of ambient temperature on capillary refill in healthy children. Pediatrics. 1993;92:699-702.
32. Schriger DL, Baraff L. Defining normal capillary refill: variation with age, sex, and temperature. Ann Emerg Med. 1988;17:932-5.
33. Pamba A, Maitland K. Capillary refill: prognostic value in Kenyan children. Arch Dis Child. 2004;89:950-5.
34. Kochar DK, Singh P, Agarwal P, Kochar SK, Pokharna R, Sareen PK. Malarial hepatitis. J Assoc Physicians India. 2003;51:1069-72.
35. Nacher M, Treeprasertsuk S, Singhasivanon P, Silachamroon U, Vannaphan S, Gay F, et al. Association of hepatomegaly and jaundice with acute renal failure but not with cerebral malaria in severe falciparum malaria in Thailand. Am J Trop Med Hyg. 2001;65:828-33.
36. Mishra SK, Mohanty S, Satpathy SK, Mohapatra DN. Cerebral malaria in adults –a description of 526 cases admitted to Ispat General Hospital in Rourkela, India. Ann Trop Med Parasitol. 2007;101:187-93.
37. Campuzano G, Arbeláez M. Uroanálisis: más que un exa-men de rutina. Medicina y Laboratorio. 2006;12:511-56.
38. Giraldo C, Blair S. Complicaciones renales en malaria. Acta Med Colomb. 2004 29:328-36.
39. O’Donnell A, Weatherall DJ, Taylor AM, Reeder JC, Allen SJ. Muscle cell injury, haemolysis and dark urine in children with falciparum malaria in Papua New Guinea. Trans R Soc Trop Med Hyg. 2006;100:817-25.
40 Muhe L, Oljira B, Degefu H, Jaffar S, Weber MW. Evaluation of clinical pallor in the identification and treatment of children with moderate and severe anaemia. Trop Med Int Health. 2000;5:805-10.
41 Luby SP, Kazembe PN, Redd SC, Ziba C, Nwanyanwu OC, Hightower AW, et al. Using clinical signs to diagnose anaemia in African children. Bull World Health Org. 1995;73:477-82.
42 Arboleda M, Campuzano M, Restrepo BN, Cartagena G. El comportamiento clínico del dengue en pacientes hospitalizados en el Hospital Antonio Roldán Betancur, Apartado, Antioquia, 2000. Biomédica. 2006;26:286-94.
43 Gear JH. The hemorrhagic fevers of Southern Africa with special reference to studies in the South African Institute for Medical Research. Yale J Biol Med. 1982;55:207-12.
44 Brogan PA, Raffles A. The management of fever and petechiae: making sense of rash decisions. Arch Dis Child. 2000;83:506-7.
45 Ministerio de Salud. Guía de atención de la malaria. Norma técnica 31/03/2000. Diario oficial 43.956. Bogotá D.C.: Ministerio de Salud; 2000.
46 World Health Organization. Guidelines for the treatment of malaria. Documento WHO/HTM/MAL/2006.1108. Geneva: WHO; 2006. p. 266.
47 World Health Organization. Management of severe mala-ria. A practical handbook. Geneva: WHO; 2000. p.78.
2. Idro R, Bitarakwate E, Tumwesigire S, John CC. Clinical manifestations of severe malaria in the highlands of southwestern Uganda. Am J Trop Med Hyg. 2005;72:561-7.
3. Organización Mundial de la Salud, Organización Panamericana de la Salud. Evaluación de la eficacia terapéutica de los medicamentos para el tratamiento del paludismo por Plasmodium falciparum sin complicaciones en las Américas. Documento OPS/HCP/HCT/113/98. Washington, D.C.: OPS; 1998.
4. World Health Organization. A manual for community health workers. Geneva; World Health Organization; 1996. p. 46.
5. World Health Organization. Integrated management of childhood illness: conclusions. WHO Division of Child Health and Development. Bull World Health Org. 1997;75(Suppl.1):119-28.
6. World Health Organization. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg. 2000;94(Suppl.1):S1-90.
7. Baird JK. Neglect of Plasmodium vivax malaria. Trends Parasitol. 2007;23:533-9.
8. Price L, Planche T, Rayner C, Krishna S. Acute respiratory distress syndrome in Plasmodium vivax malaria: case report and review of the literature. Trans R Soc Trop Med Hyg. 2007;101:655-9.
9. Padilla JC, Piñeros JG. Situación de la malaria en el Pacífico nariñense durante el año 2001. Inf Quinc Epidemiol Nac. 2001;6:269-73.
10. González L, Guzmán M, Carmona J, Lopera T, Blair S. Características clínico-epidemiológicas de 291 pacientes hospitalizados por malaria en Medellín (Colombia). Acta Med Colomb. 2000;25:163-7.
11. Tobón A, Giraldo C, Piñeros J, Arboleda M, Blair S, Carmona J. Epidemiología de la malaria falciparum complicada: estudio de casos y controles en Tumaco y Turbo, Colombia, 2003. Rev Bras Epidemiol. 2006;9:283-96.
12. Ministerio de Salud de Colombia, Grupo de Malaria Universidad de Antioquia, CIDEIM, Instituto Nacional de Salud, OPS. Manual de operaciones de la red de farmacovigilancia en malaria en Colombia. Evaluación in vivo. Buenaventura (Colombia). Bogotá: Ministerio de Salud de Colombia; Grupo de Malaria, Universidad de Antioquia; CIDEIM; Instituto Nacional de Salud; OPS; 2002. p. 32.
13. Bouchaud O. Diagnosis and management of imported malaria. Rev Prat. 2005;55:863-74.
14. Makani J, Matuja W, Liyombo E, Snow RW, Marsh K, Warrell DA. Admission diagnosis of cerebral malaria in adults in an endemic area of Tanzania: implications and clinical description. QJM. 2003;96:355-62.
15. Newton CR, Hien TT, White N. Cerebral malaria. J Neurol Neurosurg Psychiatry. 2000;69:433-41.
16. Anstey NM, Jacups SP, Cain T, Pearson T, Ziesing PJ, Fisher DA, et al. Pulmonary manifestations of uncomplicated falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis. 2002;185:1326-34.
17. Giraldo C, Blair S, Tobón A. Complicaciones pulmonares en malaria. Infectio. 2004;8:279-91
18. English M, Waruiru C, Amukoye E, Murphy S, Crawley J, Mwangi I, et al. Deep breathing in children with severe malaria: indicator of metabolic acidosis and poor outcome. Am J Trop Med Hyg. 1996;55:521-4.
19. Brandts C, Ndjavé M, Graninger W, Kremsner P. Effect of paracetamol on parasite clearance time in malaria. Lancet. 1997;350:704-9.
20. Seoh JY, Khan M, Park SH, Park HK, Shin MH, Ha EH, et al. Serum cytokine profiles in patients with Plasmodium vivax malaria: a comparison between those who presented with and without hyperpyrexia. Am J Trop Med Hyg. 2003;68:102-6.
21. Eiam-Ong S, Sitprija V. Falciparum malaria and the kidney: a model of inflammation. Am J Kidney Dis. 1998;32:361-75.
22. Peres Bota D, Lopes Ferreira F, Melot C, Vincent JL. Body temperature alterations in the critically ill. Intensive Care Med. 2004;30:811-6.
23. Idro R, Karamagi C, Tumwine J. Immediate outcome and prognostic factors for cerebral malaria among children admitted to Mulago Hospital, Uganda. Ann Trop Paediatr. 2004;24:17-24.
24. Popov AF. Algid malaria. Med Parazitol (Mosk). 2005;1:10-2.
25. Ustianowski A, Schwab U, Pasvol G. Case report: severe acute symptomatic hyponatraemia in falciparum malaria. Trans R Soc Trop Med Hyg. 2002;96:647-8.
26. Sasi P, English M, Berkley J, Lowe B, Shebe M, Mwakesi R, et al. Characterization of metabolic acidosis in Kenyan children admitted to hospital for acute non-surgical conditions. Trans R Soc Trop Med Hyg. 2006;100:401-9.
27. Molyneux ME, Looareesuwan S, Menzies IS, Grainger SL, Phillips RE, Wattanagoon Y, et al. Reduced hepatic blood flow and intestinal malabsorption in severe falciparum malaria. Am J Trop Med Hyg. 1989;40:470-6.
28. Reisinger EC, Fritzsche C, Krause R, Krejs GJ. Diarrhea caused by primarily non-gastrointestinal infections. Nat Clin Pract Gastroenterol Hepatol. 2005;2:216-22.
29. Planche T, Onanga M, Schwenk A, Dzeing A, Borrmann S, Faucher JF, et al. Assessment of volume depletion in children with malaria. PLoS Med. 2004;1:56-63.
30. Maitland K, Levin M, English M, Mithwani S, Peshu N, Marsh K, et al. Severe P. falciparum malaria in Kenyan children: evidence for hypovolaemia. QJM. 2003;96:427-34.
31. Gorelick MH, Shaw KN, Baker MD. Effect of ambient temperature on capillary refill in healthy children. Pediatrics. 1993;92:699-702.
32. Schriger DL, Baraff L. Defining normal capillary refill: variation with age, sex, and temperature. Ann Emerg Med. 1988;17:932-5.
33. Pamba A, Maitland K. Capillary refill: prognostic value in Kenyan children. Arch Dis Child. 2004;89:950-5.
34. Kochar DK, Singh P, Agarwal P, Kochar SK, Pokharna R, Sareen PK. Malarial hepatitis. J Assoc Physicians India. 2003;51:1069-72.
35. Nacher M, Treeprasertsuk S, Singhasivanon P, Silachamroon U, Vannaphan S, Gay F, et al. Association of hepatomegaly and jaundice with acute renal failure but not with cerebral malaria in severe falciparum malaria in Thailand. Am J Trop Med Hyg. 2001;65:828-33.
36. Mishra SK, Mohanty S, Satpathy SK, Mohapatra DN. Cerebral malaria in adults –a description of 526 cases admitted to Ispat General Hospital in Rourkela, India. Ann Trop Med Parasitol. 2007;101:187-93.
37. Campuzano G, Arbeláez M. Uroanálisis: más que un exa-men de rutina. Medicina y Laboratorio. 2006;12:511-56.
38. Giraldo C, Blair S. Complicaciones renales en malaria. Acta Med Colomb. 2004 29:328-36.
39. O’Donnell A, Weatherall DJ, Taylor AM, Reeder JC, Allen SJ. Muscle cell injury, haemolysis and dark urine in children with falciparum malaria in Papua New Guinea. Trans R Soc Trop Med Hyg. 2006;100:817-25.
40 Muhe L, Oljira B, Degefu H, Jaffar S, Weber MW. Evaluation of clinical pallor in the identification and treatment of children with moderate and severe anaemia. Trop Med Int Health. 2000;5:805-10.
41 Luby SP, Kazembe PN, Redd SC, Ziba C, Nwanyanwu OC, Hightower AW, et al. Using clinical signs to diagnose anaemia in African children. Bull World Health Org. 1995;73:477-82.
42 Arboleda M, Campuzano M, Restrepo BN, Cartagena G. El comportamiento clínico del dengue en pacientes hospitalizados en el Hospital Antonio Roldán Betancur, Apartado, Antioquia, 2000. Biomédica. 2006;26:286-94.
43 Gear JH. The hemorrhagic fevers of Southern Africa with special reference to studies in the South African Institute for Medical Research. Yale J Biol Med. 1982;55:207-12.
44 Brogan PA, Raffles A. The management of fever and petechiae: making sense of rash decisions. Arch Dis Child. 2000;83:506-7.
45 Ministerio de Salud. Guía de atención de la malaria. Norma técnica 31/03/2000. Diario oficial 43.956. Bogotá D.C.: Ministerio de Salud; 2000.
46 World Health Organization. Guidelines for the treatment of malaria. Documento WHO/HTM/MAL/2006.1108. Geneva: WHO; 2006. p. 266.
47 World Health Organization. Management of severe mala-ria. A practical handbook. Geneva: WHO; 2000. p.78.
How to Cite
1.
Tobón A. Danger signs in the malaria patient. biomedica [Internet]. 2009 Jun. 1 [cited 2024 May 18];29(2):320-9. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/33
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