Evidence and Implications of Mortality Associated with Acute Plasmodium vivax Malaria

Abstract

SUMMARYVivax malaria threatens patients despite relatively low-grade parasitemias in peripheral blood. The tenet of death as a rare outcome, derived from antiquated and flawed clinical classifications, disregarded key clinical evidence, including (i) high rates of mortality in neurosyphilis patients treated with vivax malaria; (ii) significant mortality from zones of endemicity; and (iii) the physiological threat inherent in repeated, very severe paroxysms in any patient, healthy or otherwise. The very well-documented course of this infection, with the exception of parasitemia, carries all of the attributes of “perniciousness” historically linked to falciparum malaria, including severe disease and fatal outcomes. A systematic analysis of the parasite biomass in severely ill patients that includes blood, marrow, and spleen may ultimately explain this historic misunderstanding. Regardless of how this parasite is pernicious, recent data demonstrate that the infection comes with a significant burden of morbidity and associated mortality. The extraordinary burden of malaria is not heavily weighted upon any single continent by a single species of parasite—it is a complex problem for the entire endemic world, and both species are of fundamental importance. Humanity must rally substantial resources, intellect, and energy to counter this daunting but profound threat.

Relapse of a Plasmodium vivax Infection in an Iranian Patient: A Case Report

“…Primaquine, 8-aminoquinoline" has remained the only drug to resolve the latent phase of P. vivax in the liver (2,9,12). Primaquine can lead to deadly hemolysis in patients with glucose 6 phosphate dehydrogenase (G6PD) deficiency (2).…”

To Study Clinical Profile and Complications of Plasmodium Vivax Malaria

“…Plasmodium vivax is not generally regarded as sufficiently virulent to cause death. Notwithstanding this benign reputation, over the last two to three decades, there have been multiple case studies of fatal vivax malaria (10,11) More recently, hospital and outpatient surveillance systems have shown that P. vivax-associated mortality may be occurring with greater frequency than previously thought or reported (12,13) In the present study, the most common age group amongst study population was 21 to 30 years (48%) followed by 41 to 50 years (17.3%) and 31 to 40 years (14.7%). This is in accordance to study conducted by Dilip R Patil et al, (14) in which also higher incidence of vivax malaria was seen in the age group of 21 to 30 (23.53%).…”

Antimalarial Treatment Outcomes In Ethiopia: A Systematic Review And Meta-Analysis

“…Plasmodium falciparum is the most common (64%) cause of malaria in Ethiopia while P. vivax accounts for the remaining cases (34%) [3]. Plasmodium falciparum causes the most severe form of malaria, however, contrary to popular belief, P. vivax can also cause severe malaria and even death [5] and Ethiopia is home to the second highest number of cases [12% (n ~1020)] and mortality [12% (n ~372)] due to P. vivax (next only to India) in the world [2]. Malaria due to P. vivax and P. ovale are also characterized by relapses [6].…”