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Mala W, Wilairatana P, Samerjai C, Masangkay FR, Kotepui KU, Kotepui M. Prevalence of Signs of Severity Identified in the Thai Population with Malaria: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031196. [PMID: 35162229 PMCID: PMC8834971 DOI: 10.3390/ijerph19031196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023]
Abstract
Understanding the prevalence of signs of severity identified in the Thai population with malaria could aid clinical management and disease control efforts, decrease mortality, and promote malaria elimination in Thailand. This systematic review aimed to collate the evidence regarding signs of severity identified in the Thai population with malaria. MEDLINE, Web of Science, and Scopus were searched for potentially relevant studies. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. The pooled prevalence of signs of severity among patients with severe malaria and the pooled proportion of each sign of severity among all signs of severity were estimated using random-effects models. Heterogeneity among included studies was assessed using Cochran’s Q test. A subgroup analysis was performed to evaluate whether differences in pooled estimates between different study sites. Publication bias was assessed by visualizing funnel plot asymmetry and using Egger’s test. Among 741 studies identified by literature searching, 12 studies of a total of 2900 patients with severe malaria, in 7 Thai hospitals, met the eligibility criteria. Results of meta-analyses showed that the signs of the severity of malaria with the highest prevalence in Thailand were jaundice (54%), hyperparasitemia (47%), impaired consciousness/coma (21%), acidosis (18%), renal impairment (13%), shock (10%), convulsions (9%), severe anemia (8%), pulmonary edema/acute respiratory distress syndrome (ARDS) (8%), hypoglycemia (4%), and bleeding/disseminated intravascular coagulation (DIC) (2%). The signs of the severity of malaria that made up the highest proportion of all signs of severity identified in the Thai population with malaria were hyperparasitemia (33%), jaundice (33%), impaired consciousness/coma (12%), acidosis (9%), renal impairment (7%), severe anemia (6%), convulsions (5%), shock (5%), pulmonary edema/ARDS (3%), bleeding/DIC (1%), and hypoglycemia (1%). The present study revealed the prevalence of signs of severity identified in the Thai population with malaria. Jaundice, hyperparasitemia, and impaired consciousness/coma were the most common signs of severity identified. These results may inform the management of patients with severe malaria and promote malaria-elimination efforts in Thailand.
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Affiliation(s)
- Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Chutharat Samerjai
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | | | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
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Malaria Cases in a Tertiary Hospital in Kuala Lumpur, Malaysia: A 16-Year (2005-2020) Retrospective Review. Trop Med Infect Dis 2021; 6:tropicalmed6040177. [PMID: 34698312 PMCID: PMC8544725 DOI: 10.3390/tropicalmed6040177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/26/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022] Open
Abstract
While there has been a tremendous decline in malaria disease burden in the remote parts of Malaysia, little is known about malaria incidence in its urban localities. This study aimed to analyze trends of malaria cases in urban Kuala Lumpur, Malaysia. All suspected cases presented to a university hospital in Kuala Lumpur from January 2005 to December 2020 were examined by microscopy. Infection status was analyzed using descriptive statistics and curve estimation analysis. Of 3105 blood films examined, 92 (3%) were microscopically confirmed malaria cases. Plasmodium vivax infections accounted for the majority (36.9%) of all malaria cases. Nearly half (47.8%) of cases were found among foreign cases (p < 0.001). The majority of foreign cases were male (86.4%) and came from Southeast Asian countries (65.9%). The curve estimation analysis showed significant decreases in malaria cases due to P. vivax (R2 = 0.598; p < 0.001) and Plasmodium falciparum (R2 = 0.298, p = 0.029), but increases for Plasmodium knowlesi (R2 = 0.325, p = 0.021) during the 16 years. This study showed that malaria incidence in urban Kuala Lumpur is low and has remained stable since 2005. However, P. knowlesi has played a significant role in the increase in overall malaria in the area, highlighting the importance of continued vigilance and improved surveillance.
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Yavne Y, Leshem E, Paran Y, Nadir E, Weinberger M, Stein M, Petersiel N, Yahav D, Grossman T, Schwartz E. Plasmodium malariae in Israeli Travelers: A Nationwide Study. Clin Infect Dis 2018; 65:1516-1522. [PMID: 29020345 DOI: 10.1093/cid/cix560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/18/2017] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about Plasmodium malariae, a relatively rare cause of malaria in returned travelers. Recently, polymerase chain reaction (PCR) use for malaria diagnosis has enhanced specificity of P. malariae detection. The study objective was to describe the unique aspects of P. malariae diagnosis and clinical course in travelers. Methods Malaria is a reportable disease in Israel. All PCR-proven P. malariae monoinfections in Israeli travelers between January 2008 and January 2017 were retrieved from the Ministry of Health Reference Parasitology Laboratory. Data regarding method and timing of diagnosis, clinical characteristics, and laboratory testing were collected from patient charts. Results Eighteen patients with P. malariae were included. All cases were acquired in Africa. During the study period, the relative proportion of P. malariae increased (2%-10% of all malaria cases). Malaria was identified by blood smear in 10 of 18 patients (56%) on admission, and by rapid antigen test in 5 of 18 (29%) patients only, while P. malariae speciation was correctly identified by smear in 2 of 18 (11%) patients. Though all patients reported fever, only 4 of 18 (22%) described a quartan fever course. In 7 of 18 (39%) patients, malaria was contracted despite prophylactic treatment. Five patients had prolonged prepatent periods (median, 55 days), all of whom received prior prophylaxis. Conclusions The relative proportion of P. malariae is on the rise. Diagnosis in routine clinical settings is inadequate due to the low sensitivity and specificity of blood smears. PCR should be considered when clinical suspicion is high. Prophylaxis failure, which caused delayed clinical presentation, was documented.
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Affiliation(s)
- Yarden Yavne
- Sackler Faculty of Medicine, Tel-Aviv University
| | - Eyal Leshem
- Sackler Faculty of Medicine, Tel-Aviv University.,Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer
| | - Yael Paran
- Sackler Faculty of Medicine, Tel-Aviv University.,Infectious Diseases Unit, Sourasky Medical Center, Tel Aviv
| | - Eyal Nadir
- Infectious Diseases Unit, Kaplan Medical Center, Rehovot, affiliated to the School of Medicine, Hebrew University and Hadassah, Jerusalem
| | - Miriam Weinberger
- Sackler Faculty of Medicine, Tel-Aviv University.,Infectious Diseases Unit, Assaf Harofeh Medical Center
| | - Michal Stein
- Infectious Diseases Unit, Hillel Yaffe Medical Center, Hadera
| | - Neta Petersiel
- Unit of Infectious Diseases and Internal Medicine B, Rambam Medical Center and Bruce Rappaport Faculty of Medicine, Technion, Haifa
| | - Dafna Yahav
- Unit of Infectious Diseases, Rabin Medical Center, Beilinson Hospital, Petah-Tikva
| | - Tamar Grossman
- Reference Parasitology Laboratory, Central Laboratories, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Eli Schwartz
- Sackler Faculty of Medicine, Tel-Aviv University.,Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer
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Val F, Avalos S, Gomes AA, Zerpa JEA, Fontecha G, Siqueira AM, Bassat Q, Alecrim MGC, Monteiro WM, Lacerda MVG. Are respiratory complications of Plasmodium vivax malaria an underestimated problem? Malar J 2017; 16:495. [PMID: 29273053 PMCID: PMC5741897 DOI: 10.1186/s12936-017-2143-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/18/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Respiratory complications are uncommon, but often life-threatening features of Plasmodium vivax malaria. This study aimed to estimate the prevalence and lethality associated with such complications among P. vivax malaria patients in a tertiary hospital in the Western Brazilian Amazon, and to identify variables associated with severe respiratory complications, intensive care need and death. Medical records from 2009 to 2016 were reviewed aiming to identify all patients diagnosed with P. vivax malaria and respiratory complications. Prevalence, lethality and risk factors associated with WHO defined respiratory complications, intensive care need and death were assessed. RESULTS A total of 587 vivax malaria patients were hospitalized during the study period. Thirty (5.1%) developed respiratory complications. Thirteen (43.3%) developed severe respiratory complications, intensive care was required for 12 (40%) patients and 5 (16.6%) died. On admission, anaemia and thrombocytopaenia were common findings, whereas fever was unusual. Patients presented different classes of parasitaemia and six were aparasitaemic on admission. Time to respiratory complications occurred after anti-malarials administration in 18 (60%) patients and progressed very rapidly. Seventeen patients (56.7%) had comorbidities and/or concomitant conditions, which were significantly associated to higher odds of developing severe respiratory complications, need for intensive care and death (p < 0.05). CONCLUSION Respiratory complications were shown to be associated with significant mortality in this population. Patients with comorbidities and/or concomitant conditions require special attention to avoid this potential life-threatening complication.
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Affiliation(s)
- Fernando Val
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil. .,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
| | - Sara Avalos
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - André Alexandre Gomes
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - José Evelio Albornoz Zerpa
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - André Machado Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Quique Bassat
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain.,Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain.,Universidad Europea de Madrid, Madrid, Spain
| | - Maria Graças Costa Alecrim
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil. .,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
| | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.,Instituto de Pesquisas Leônidas and Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
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Val F, Machado K, Barbosa L, Salinas JL, Siqueira AM, Costa Alecrim MG, del Portillo H, Bassat Q, Monteiro WM, Guimarães Lacerda MV. Respiratory Complications of Plasmodium vivax Malaria: Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2017; 97:733-743. [PMID: 28722625 PMCID: PMC5590608 DOI: 10.4269/ajtmh.17-0131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 04/19/2017] [Indexed: 12/12/2022] Open
Abstract
Malaria, a major global public health problem, is mainly caused by Plasmodium falciparum and Plasmodium vivax, and is responsible for nearly half a million deaths annually. Although P. vivax malaria was not believed to cause severe disease, recent robust studies have proved otherwise. However, the clinical spectrum and pathogenesis of severe vivax malaria and, especially, its respiratory complications remain poorly understood. A systematic search for articles reporting respiratory complications associated with vivax malaria was performed in Lilacs, Cochrane, Scielo, Web of Science, and Medline databases irrespective of publication date. Prevalence of acute respiratory distress syndrome (ARDS) and associated mortality among vivax patients were calculated from cross-sectional and longitudinal studies, whereas factors associated with mortality were calculated from data pooled from case reports and series of cases. A total of 101 studies were included (49 cross-sectional or longitudinal and 52 case reports or series of cases). Prevalence of ARDS was 2.8% and 2.2% in children and adults, respectively, with nearly 50% mortality. Moreover, female sex (P = 0.013), having any comorbidity (P = 0.036), lower body temperature (P = 0.032), lower hemoglobin (P = 0.043), and oxygen saturation (P = 0.053) values were significantly associated with mortality. Plasmodium vivax malaria respiratory complications included ARDS and were associated with high mortality. Demographics and clinical characteristics upon presentation to hospital were associated with mortality among patients with respiratory complications in vivax malaria. This study reaffirms the evidence of severe and fatal complications of P. vivax malaria and its associated respiratory complications.
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Affiliation(s)
- Fernando Val
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Kim Machado
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Lisiane Barbosa
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | - André Machado Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maria Graças Costa Alecrim
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Hernando del Portillo
- Barcelona Institute for Global Health (ISGlobal) and ICREA and Institut d’Investigacioì Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Quique Bassat
- Barcelona Institute for Global Health (ISGlobal) and ICREA, Badalona, Spain
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
- Instituto de Pesquisas Leônidas and Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
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Travel medicine in Oman--Chances and challenges. Travel Med Infect Dis 2015; 13:351-2. [PMID: 26454567 DOI: 10.1016/j.tmaid.2015.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 11/24/2022]
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Marti H, Stalder C, González IJ. Diagnostic accuracy of a LAMP kit for diagnosis of imported malaria in Switzerland. Travel Med Infect Dis 2015; 13:167-71. [DOI: 10.1016/j.tmaid.2014.12.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/24/2014] [Accepted: 12/27/2014] [Indexed: 11/24/2022]
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