BackgroundMalaria incidence has recently decreased globally and, as malaria elimination is envisioned as a possibility by the health authorities, guidance is needed to strengthen malaria control strategies. Larval source treatment, which could complement routine vector control strategies, requires knowledge regarding the Anopheles larval habitats.MethodsA cross-sectional study was conducted in three of the most malaria-endemic regions in Colombia. A total of 1116 potential larval habitats in 70 villages were sampled in three states located in western Colombia: Cordoba, Valle del Cauca and Nariño.ResultsOverall, 17.5 % (195) of the potential larval habitats were found positive for different Anopheles species. A total of 1683 larvae were identified belonging to seven species: Anophelesalbimanus, Anopheles calderoni, Anophelesdarlingi, Anophelesneomaculipalpus, Anophelesnuneztovaris.l., Anophelespseudopunctipennis, and Anophelestriannulatus. The most widely distributed species was An. nuneztovari s.l., which was found mainly in human-made fishponds in Cordoba and temporary puddles in Valle del Cauca. Anophelesalbimanus and An. calderoni were associated with human-made wells or excavation sites in Nariño. Cordoba displayed the greatest Anopheles species diversity with a total of six species (Shannon diversity index H′: 1.063). Although Valle del Cauca had four species, one more than Nariño, the diversity was lower because only one species predominated, An. nuneztovari s.l. The larval habitats with the highest Shannon diversity index were lagoons (H′: 1.079) and fishponds (H′: 1.009) in Cordoba, excavation sites in Nariño (H′: 0.620) and puddles in Valle del Cauca (H′: 0.764).ConclusionsThis study provides important information regarding the larval habitats of the main malaria vectors in the most malaria-endemic regions of Colombia, which will be useful in guiding larval control operations.

Information on malaria-associated anemia in adult patients is scarce in South American populations. From 2004 to 2006, malaria patients 18 to 45 years of age were recruited in a descriptive cross-sectional study from two different towns: Manaus, in the Brazilian Amazon (120 patients) where Plasmodium falciparum incidence is lower ( approximately 20%), and in Tumaco on the Colombian Pacific Coast (126 patients) where P. falciparum incidence is higher ( approximately 90%). Relationships between hematologic parameters and independent variables were explored using cross-tabulations and multiple linear regression analyses. We found an inverse relationship of hemoglobin (Hb) levels with days of illness in both sites. In Manaus but not in Tumaco, red cell distribution width (RDW) was related to asexual parasitemia. Reticulocytes were higher in Plasmodium vivax infection in Tumaco. Only in Tumaco, two patients with P. falciparum infection presented with severe anemia (Hb < 7 g/dL). Etiologic factors associated with hematologic changes in malaria seem to be multifactorial. More studies are needed to clarify the anemia determinants in uncomplicated malaria in South America, where malaria transmission is mostly unstable.

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Anemia is a common complication of human malaria. Since micronutrient deficiencies are highly prevalent in malaria-endemic areas and appear to contribute to anemia etiology, we conducted a cross-sectional study in Tumaco, Colombia, to examine the associations between plasma vitamin B12 or erythrocyte folate concentrations and hemoglobin (Hb) among 96 adults with predominantly Plasmodium falciparum malaria. Prevalence of folate and vitamin B12 deficiencies were 26.0% and 26.6%, respectively. There was an inverse, linear relation between folate and Hb concentrations. Adjusted difference in Hb between lowest and highest folate quartiles was 1 g/dL (p = 0.04; p, test for trend = 0.01). Vitamin B12 was not associated with Hb concentrations and did not modify the associations between folate and Hb. Incidentally, body mass index (BMI) was inversely associated with parasitemia and risk of clinical malaria. Future longitudinal studies are warranted to determine the potential pathophysiological role of folate in malaria-related anemia.

Cerebral venous sinus thrombosis (CVST) in childhood is uncommon. Certain diseases predispose patients to CVST, such as inflammatory bowel disease (IBD), which is considered a risk factor for developing thrombosis, which in turn is considered an extraintestinal manifestation of IBD. The use of prophylaxis in certain patients is a controversial topic. We present the case of a 5-years-old child with ulcerative colitis, who presented with transverse sinus thrombosis immediately after colectomy. Considering the recent recommendations on prophylaxis in this disease, our patient and probably many others would benefit from establishing treatment with low-molecular-weight heparin. We believe that these recommendations should be known, with our case serving as an example, given that we are heading in a direction that has so far been controversial.