Concurrent dengue and malaria in the Amazon region

Santana, Vinicius dos Santos; Lavezzo, Lígia Carolina; Terzian, Ana Carolina Bernardes; Bronzoni, Roberta Vieira de Morais; Rossit, Andréa Regina Baptista; Machado, Ricardo Luiz Dantas; Rahal, Paula; Nogueira, Mara Corrêa Lelles; Nogueira, Maurício Lacerda

doi:10.1590/s0037-86822010000500007

Cited by 37 publications

(28 citation statements)

References 20 publications

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“…There were isolated case reports in India [7, 20–24], East Timor [12], Japan [17], Bangladesh [13], Indonesia [14], Malaysia [16], and Cambodia [15]. Following that, a series of cases were reported in French Guiana [25, 26], Brazil [11, 27], India [28–30], Bangladesh [31], Pakistan [10], Peru [32], and Kenya [33]. …”

Section: Discussionmentioning

confidence: 99%

The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection

Chong

Zaini

Suraiya

et al. 2017

Malar J

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BackgroundDengue and malaria are two common, mosquito-borne infections, which may lead to mortality if not managed properly. Concurrent infections of dengue and malaria are rare due to the different habitats of its vectors and activities of different carrier mosquitoes. The first case reported was in 2005. Since then, several concurrent infections have been reported between the dengue virus (DENV) and the malaria protozoans, Plasmodium falciparum and Plasmodium vivax. Symptoms of each infection may be masked by a simultaneous second infection, resulting in late treatment and severe complications. Plasmodium knowlesi is also a common cause of malaria in Malaysia with one of the highest rates of mortality. This report is one of the earliest in literature of concomitant infection between DENV and P. knowlesi in which a delay in diagnosis had placed a patient in a life-threatening situation.Case presentationA 59-year old man staying near the Belum-Temengor rainforest at the Malaysia–Thailand border was admitted with fever for 6 days, with respiratory distress. His non-structural protein 1 antigen and Anti-DENV Immunoglobulin M tests were positive. He was treated for severe dengue with compensated shock. Treating the dengue had so distracted the clinicians that a blood film for the malaria parasite was not done. Despite aggressive supportive treatment in the intensive care unit (ICU), the patient had unresolved acidosis as well as multi-organ failure involving respiratory, renal, liver, and haematological systems. It was due to the presentation of shivering in the ICU, that a blood film was done on the second day that revealed the presence of P. knowlesi with a parasite count of 520,000/μL. The patient was subsequently treated with artesunate-doxycycline and made a good recovery after nine days in ICU.ConclusionsThis case contributes to the body of literature on co-infection between DENV and P. knowlesi and highlights the clinical consequences, which can be severe. Awareness should be raised among health-care workers on the possibility of dengue-malaria co-infection in this region. Further research is required to determine the real incidence and risk of co-infection in order to improve the management of acute febrile illness.

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Section: Discussionmentioning

confidence: 99%

The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection

Chong

Zaini

Suraiya

et al. 2017

Malar J

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“…Since the first case reported in 2005 [1], only case-reports and two descriptive studies have been published. They have been reported with Plasmodium falciparum and/or Plasmodium vivax in India and Pakistan [2-5], Southeast Asia [6,7], French Guiana [8] and Brazil [9]. This phenomenon seems to be uncommon.…”

Section: Introductionmentioning

confidence: 99%

Is dengue and malaria co-infection more severe than single infections? A retrospective matched-pair study in French Guiana

Epelboin

Hanf

Dussart

et al. 2012

Malar J

114

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BackgroundDengue and malaria are two major arthropod-borne infections in tropical areas, but dual infections were only described for the first time in 2005. Reports of these concomitant infections are scarce and there is no evidence of more severe clinical and biological pictures than single infections.MethodsTo compare co-infections to dengue alone and malaria alone, a retrospective matched-pair study was conducted between 2004 and 2010 among patients admitted in the emergency department of Cayenne hospital, French Guiana.Results104 dengue and malaria co-infection cases were identified during the study period and 208 individuals were matched in two comparison groups: dengue alone and malaria alone. In bivariate analysis, co-infection clinical picture was more severe than separated infections, in particular using the severe malaria WHO criteria. In multivariate analysis, independent factors associated with co-infection versus dengue were: masculine gender, CRP level > 50 mg/L, thrombocytopaenia < 50 109/L, and low haematocrit <36% and independent factors significantly associated with co-infections versus malaria were red cells transfusion, low haematocrit < 36%, thrombocytopaenia < 50 109/L and low Plasmodium parasitic load < 0.001%.ConclusionsIn the present study, dengue and malaria co-infection clinical picture seems to be more severe than single infections in French Guiana, with a greater risk of deep thrombocytopaenia and anaemia.

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“…A clinically identifiable focus of infection included acute otitis media, sinusitis, purulent pharyngitis, cellulitis, acute urinary tract infection, dental caries, septic arthritis, pneumonia, pelvic inflammatory illness or peritonitis. Identification of malaria on blood films was not an exclusion criterion, as asymptomatic Plasmodium parasitaemia is well-described in endemic regions of Peru [17] and multiple etiologies of acute febrile illness have been detected in prior studies in the Amazon basin [18,19]. …”

Section: Methodsmentioning

confidence: 99%

Detection of human leptospirosis as a cause of acute fever by capture ELISA using a Leptospira interrogansserovar Copenhageni (M20) derived antigen

et al. 2013

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BackgroundLeptospirosis is a potentially lethal zoonosis mainly affecting low-resource tropical countries, including Peru and its neighbouring countries. Timely diagnosis of leptospirosis is critical but may be challenging in the regions where it is most prevalent. The serodiagnostic gold standard microagglutination test (MAT) may be technically prohibitive. Our objective in this study was to assess the sensitivity, specificity, and predictive value of an IgM antibody capture enzyme-linked immunoassay (MAC-ELISA) derived from the M20 strain of Leptospira interrogans serovar Copenhageni (M20) by comparison to MAT, which was used as the gold standard method of diagnosis.MethodsAcute and convalescent sera from participants participating in a passive febrile surveillance study in multiple regions of Peru were tested by both IgM MAC-ELISA and MAT. The sensitivity, specificity, positive and negative predictive value (PPV, NPV) of the MAC-ELISA assay for acute, convalescent and paired sera by comparison to MAT were calculated.ResultsThe sensitivity, specificity, PPV and NPV of the MAC-ELISA assay for acute sera were 92.3%, 56.0%, 35.3% and 96.6% respectively. For convalescent sera, the sensitivity, specificity, PPV and NPV of the MAC-ELISA assay were 93.3%, 51.5%, 63.6% and 89.5% respectively. For paired sera, the sensitivity, specificity, PPV and NPV of the MAC-ELISA assay were 93.6%, 37.5%, 59.2%, 85.7% respectively.ConclusionsThe M20 MAC-ELISA assay performed with a high sensitivity and low specificity in the acute phase of illness. Sensitivity was similar as compared with MAT in the convalescent phase and specificity remained low. Paired sera were the most sensitive but least specific by comparison to MAT serodiagnosis. NPV for acute, convalescent and paired sera was high. The limited specificity and high sensitivity of the MAC-ELISA IgM suggests that it would be most valuable to exclude leptospirosis in low-resource regions that lack immediate access to definitive reference laboratory techniques such as MAT.

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Concurrent dengue and malaria in the Amazon region

Cited by 37 publications

References 20 publications

The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection

The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection

Is dengue and malaria co-infection more severe than single infections? A retrospective matched-pair study in French Guiana

Detection of human leptospirosis as a cause of acute fever by capture ELISA using a Leptospira interrogansserovar Copenhageni (M20) derived antigen

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