Clinical and laboratory profile of Plasmodium vivax malaria patients hospitalized in Apartadó,

Margarita Arboleda, María Fernanda Pérez, Diana Fernández, Luz Yaned Usuga, Miler Meza, .

Keywords: malaria, Plasmodium vivax, anemia, thrombocytopenia, Colombia

Abstract

Introduction. Malaria is a public health problem in the Urabá region recording rates of infection above those of the Antioquia department. The burden of vivax malaria is 78.7% and the profile of vivax malaria in this region has scarcely been studied.
Objectives. To analyze the clinical and laboratory characteristics of patients hospitalized for vivax malaria in Apartadó.
Materials and methods. We reviewed the medical records of patients with vivax malaria hospitalized in the Antonio Roldán Betancur hospital from 2004-2007.
Results. Of 359 patients with vivax malaria who requiried hospitalization, 23.1% (83/359 patients) had the following complications: severe anemia, 51.8% (43/83); severe thrombocytopenia, 15.6% (13/83); hyperbilirubinemia, 7.2 % (6/83). Some patients met several criteria for complicated malaria simultaneously, including one case of acute respiratory distress syndrome. The most significant laboratory changes were decreases in the hemoglobin, hematocrit and platelet levels, with increased levels of transaminases and bilirubin. Only 4.82% (4/83) of patients with complicated malaria were treated with intravenous quinine, no one died.
Conclusions. The elevated frequency of complicated vivax malaria found in the Uraba region in this study is noteworthy, particularly in children under 5 years. The results highlight the need to strengthen, amongst the health staff, the knowledge of the guidelines for the clinical care of malaria patients, in order to make a correct clinical diagnosis and provide appropriate treatment.

Downloads

Download data is not yet available.
  • Margarita Arboleda Instituto Colombiano de Medicinal Tropical, Universidad CES, Apartadó, Colombia
  • María Fernanda Pérez Colegio Mayor de Antioquia, Medellín, Colombia
  • Diana Fernández Grupo Malaria, Universidad de Antioquia, Medellín, Colombia
  • Luz Yaned Usuga Instituto Colombiano de Medicinal Tropical, Universidad CES, Apartadó, Colombia
  • Miler Meza Instituto Colombiano de Medicinal Tropical, Universidad CES, Apartadó, Colombia

References

World Health Organization. World Health Organization Global Malaria Programme. World Malaria Report 2008. Geneve: WHO; 2008. Fecha de consulta: 25 de marzo de 2010. Disponible en: http://www.who.int/malaria/publications/atoz/9789241563697/en/index.html

Luxemburger C, Thwai KL, White NJ, Webster HK, Kyle DE. Maelankirri L, et al. The epidemiology of malaria in a Karen population on the western border of Thailand. Trans R Soc Trop Med Hyg. 1996;90:105-11.

Zhou G, Sirichaisinthop J, Sattabongkot J, Jones J, Bjornstad ON, Yan G, et al. Spatio-temporal distribution of Plasmodium falciparum and P. vivax malaria in Thailand. Am J Trop Med Hyg. 2005;72:256-62.

Duarte EC, Gyorkos TW, Pang L, Abrahamowicz M. Epidemiology of malaria in a hypoendemic Brazilian Amazon migrant population: A cohort study. Am J Trop Med Hyg. 2004;70:229-37.

Vargas J. Prevención y control de la malaria y otras enfermedades transmitidas por vectores en el Perú. Rev Peruana Epidemiol. 2003;11:1-18.

Instituto Nacional de Salud. Estadísticas de vigilancia en salud pública, año 2008. Fecha de consulta: 24 de mayo de 2011. Disponible en: http//www.ins.gov.co/?idcategoria=1730.

Dirección Seccional de Salud y Protección Social de Antioquia. Eventos de interés en salud pública por municipio 2007-2009. Fecha de consulta: 24 de mayo de 2011. Disponible en: http://www.dssa.gov.co/index.php/estadisticas/eventos-de-salud-publica.

World Health Organization. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg. 2000;94:S1-90.

Ministerio de la Protección Social. Guía para la atención clínica integral del paciente con malaria. Bogotá, D.C.: Ministerio de la Protección Social; 2010; 1-129.

Tobón C, Giraldo C, Piñeros J, Arboleda M, Blair S, Carmona-Fonseca 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.

Echeverri M, Tobón A, Álvarez G, Carmona J, Blair S. Clinical and laboratory findings of Plasmodium vivax malaria in Colombia. Rev Inst Med Trop São Paulo. 2003;45:29-34.

Piñeros JG. Epidemiología de malaria durante el embarazo en Urabá, Colombia, 2005-2009: una construcción biosocial. Trabajo de grado (Doctor en Salud Pública) Bogotá, D.C.: Universidad Nacional de Colombia; 2011. p. 184.

World Health Organization. Management of severe malaria: A practical handbook. Second edition. Geneva: WHO; 2000.

World Health Organization. Guidelines for the treatment of malaria. Switzerland. 2006. Fecha de consulta: 29 de agosto de 2011. Disponible en: http://ec.europa.eu/echo/files/policies/sectoral/health_2006_malaria_treatment_guidelines_who.pdf.

Piñeros-Jiménez JG, Arboleda M, Jaramillo JC, Blair S. Reporte de cinco casos de malaria neonatal grave por Plasmodium vivax en Urabá, Colombia. Biomédica. 2008;28:471-9.

Lomar A, Vidal J, Lomar F, Valente BC, Janot de Matos G, Boulos M. Acute respiratory distress syndrome due to vivax malaria: Case report and literature review. Braz J Infect Dis. 2005;9:425-30.

Rifakis P, Hernández O, Fernández C, Rodríguez-Morales A, Von A, Franco-Paredes C. Atypical Plasmodium vivax malaria in a traveler: Bilateral hydronephrosis, severe thrombocytopenia, and hypotension. J Travel Med. 2008;15:119-21.

González L, Guzmán M, Carmona-Fonseca J, Lopera T, Blair S. Características clínico epidemiológicas de 291 pacientes hospitalizados por malaria en Medellín. Acta Med Colomb. 2000;25:163-70.

Alexandre M, Ferreira C, Siqueira A, Magalhães B, Mourão M, Lacerda M, et al. Severe Plasmodium vivax malaria, Brazilian Amazon. Emerg Infect Dis. 2010;16:1611-4.

Andrade B, Reis-Filho A, Souza-Neto S, Clarêncio J, Camargo L, Barral A, et. al. Severe Plasmodium vivax malaria exhibits marked inflammatory imbalance. Malar J. 2010. Fecha de consulta: 24 de mayo de 2011. Disponible en: http://www.malariajournal.com/content/9/1/13.

Genton B, D’Acremont V, Rare L, Baea K, Reeder J, Alpers M, et al. Plasmodium vivax and mixed infections are associated with severe malaria in children: A prospective cohort study from Papua New Guinea. Fecha de consulta: 27 de mayo de 2011. Disponible en: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050136.

Kakar A, Bhoi S, Prakash V, Kakar S. Profound thrombocytopenia in Plasmodium vivax malaria. Diag Microbiol Infect Dis. 1999;35:243-4.

Sarkar S, Saha K, Sekhar Das C. Three cases of ARDS: An emerging complication of Plasmodium vivax malaria. Lung India 2010;27:154-7.

Herrera A, Montoya L, Arboleda M, Ortiz L. Asociación de la malaria severa con tipo de grupo sanguíneo ABO en una zona endémica de Colombia. Rev CES Med. 2009;23:9-16.

Kochar DK, Tanwar GS, Khatri PC, Kochar SK, Sengar GS, Gupta A, et al. Clinical features of children hospitalized with malaria –A study from Bikaner, Northwest India. Am J Trop Med Hyg. 2010;83:981-9.

Llanos C, Flórez M, Arévalo-Herrera M, Herrera S. Mecanismos de generación de anemia en malaria. Colombia Médica. 2004;35:205-14.

Ríos-Orrego A, Álvarez-Castillo T, Carmona-Fonseca J, Blair-Trujillo S. Evolución temporal de las plaquetas y los anticuerpos antiplaquetarios en pacientes de área endémica con malaria no complicada. An Med Interna (Madrid). 2005;22:561-8.

Touze J, Mercier P, Rogier C, Hovette P, Schmoor P, Dabanian C. Platelet activity in malaria thrombocytopenia. Phatol Biol. 1990;38:678-81.

Kelton G, Keystone J, Moore J, Denomme G, Tozman E, Glynn M. Inmune-mediated thrombocytopenia of malaria. J Clin Inv. 1983;71:832-6.

Illamperuma C, Allen B. Pulmonary edema due to Plasmodium vivax malaria in an American missionary. Infection. 2007;35:374-6.

Anstey N, Jacups S, Cain T, Pearson T, Ziesing P, 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.

Giraldo C, Blair S, Tobón A. Complicaciones pulmonares en malaria. Infectio. 2004;8:279-91.

Tagle R, Cabanban A. Severe and complicated malaria at San Lazaro Hospital. Fecha de consulta: 24 de mayo de 2011; Disponible en: http://www.psmid.org.ph/vol21/vol21num1topic2.pdf.

Luxemburger C, Ricci F, Nosten F, Raimond D, Bathet S, WhiteN. The epidemiology of severe malaria in an area of low transmission in Thailand. Trans R Soc Trop Med Hyg. 1997;9:256-62.

Al-Mekhlafi A, Mahdy M, Azazy A, Fong M. Clinical situation of endemic malaria in Yemen. Trop Biomed. 2010;27:551-8.

Prakash J, Singh A, Gujrati S, Maheshwari A. Acute renal failure in malaria: Changing trends. Indian Journal Nephrology. 2002;12:153-7.

Arboleda M, Campuzano M, Restrepo B, Cartagena G. Caracterización clínica de los casos de dengue hospitalizados en la E.S.E. Hospital “Antonio Roldán Betancur”, Apartadó, Antioquia, Colombia. Biomédica. 2000;26:286-94.

Srinivas R, Agarwal R, Gupta D. Severe sepsis due to severe falciparum malaria and leptospirosis co-infection treated with activated protein C. Malar J. 2007;6:42.

Charrel R, Brouqui P, Foucault C, de Lamballerie X. Concurrent dengue and malaria. Emerg Infect Dis. 2005;11:1153-4.

How to Cite
1.
Arboleda M, Pérez MF, Fernández D, Usuga LY, Meza M. Clinical and laboratory profile of Plasmodium vivax malaria patients hospitalized in Apartadó,. biomedica [Internet]. 2012 Apr. 1 [cited 2024 May 18];32(sup1):58-67. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/599

Some similar items:

Published
2012-04-01
Section
Original articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code