Maternal Clinical Findings in Malaria in Pregnancy in a Region of Northwestern Colombia

Piñeros, Juan Gabriel; Tobón-Castaño, Alberto; Álvarez, Gonzalo; Portilla, Carmencita; Blair, Silvia

doi:10.4269/ajtmh.12-0205

Cited by 20 publications

(29 citation statements)

References 18 publications

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“…In agreement with the literature, the WHO criteria are too demanding, resulting in a low detection sensitivity [ 28 , 40 ]. Additionally, the national guideline criteria of abnormal hepatic dysfunction are 3,5 times more sensitive than the WHO criteria.…”

Section: Discussionsupporting

confidence: 71%

“…Additionally, the national guideline criteria of abnormal hepatic dysfunction are 3,5 times more sensitive than the WHO criteria. For this reason, it was decided to utilize an intermediate value for transaminase values of 80 IU to classify abnormal hepatic dysfunction [ 28 ]. No cases presented with acute hepatic failure as defined by King’s College criteria [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

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A descriptive study of 16 severe Plasmodium vivax cases from three municipalities of Colombia between 2009 and 2013

O’Brien

Ramirez

Martínez

2014

Malar J

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BackgroundPlasmodium vivax, the most geographically distributed cause of malaria, accounts for more than 70% of cases in the Americas. In Colombia, P. vivax was responsible for 67.3% of cases in the last five years. Despite vivax malaria impact worldwide, historically it has been neglected and considered to be a benign disease. In the last decade medical literature reports have emerged countering this benign outlook. This study pretends to describe the clinical and paraclinical profile of severe vivax malaria cases hospitalized in Tumaco, Cali, Buenaventura between 2009 and 2013, to contribute to the knowledge regarding the behaviour and clinical expression of this disease.MethodsThis is a descriptive, retrospective case-series study of 16 severe malaria vivax cases, hospitalized between 2009 and 2013, in Colombian municipalities of Tumaco, Buenaventura and Cali. Severe malaria vivax cases were defined using criteria adapted from the national guidelines. Descriptive analyses of reason for consultation, signs and symptoms, diagnosis, treatment, paraclinical characteristics, complications, and time hospitalized, were conducted.ResultsSixteen cases of severe P. vivax were analysed. Fever, chills and headache were shown to be the main admission symptoms. Elevation of total bilirubin levels in 18.75%, and severe thrombocytopaenia in 25% of cases were the main complications presented during hospitalization. All cases responded to treatment, there were no deaths.ConclusionsThe following questions derived from this study could be the basis for future research: 1) Does the time to consultation have an impact on the number of days hospitalized and how cases progress during hospitalization, 2) Are the severity criteria in WHO guidelines sensitive enough to be used in clinical practice compared to national guidelines, and 3) How does malnutrition contribute to anaemia in malaria-endemic regions.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

A descriptive study of 16 severe Plasmodium vivax cases from three municipalities of Colombia between 2009 and 2013

O’Brien

Ramirez

Martínez

2014

Malar J

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“…A higher risk of severe anaemia has been reported in P. vivax infected multigravidae [ 7 – 9 ]. Furthermore, P. vivax in Latin America has been associated with severe malaria [ 10 – 12 ], moderate-to-severe anaemia and low birth weight [ 8 ]. From ~390,000 malaria clinical cases reported in Latin America [ 13 ], low frequency of MiP cases (10 %) [ 8 , 10 – 12 , 14 ] with moderate-to-high severe cases (4–9 %) and low mortality (0–0.2 %) [ 8 , 11 , 12 ] have been observed.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, P. vivax in Latin America has been associated with severe malaria [ 10 – 12 ], moderate-to-severe anaemia and low birth weight [ 8 ]. From ~390,000 malaria clinical cases reported in Latin America [ 13 ], low frequency of MiP cases (10 %) [ 8 , 10 – 12 , 14 ] with moderate-to-high severe cases (4–9 %) and low mortality (0–0.2 %) [ 8 , 11 , 12 ] have been observed. A comparable prevalence of malaria-associated deaths has been reported in the Thai-Myanmar border where the frequencies of annual fatal cases in pregnant women for P. falciparum and P. vivax were estimated as 0.28 % (12/4158) and 0.023 % (1/4298), respectively [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Malaria in pregnancy: a passive surveillance study of pregnant women in low transmission areas of Colombia, Latin America

Lopez-Perez

Pacheco

Buriticá

et al. 2016

Malar J

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BackgroundMalaria causes a significant burden in highly endemic areas where children and pregnant women are more susceptible to severe disease and death, however, in low transmission settings malaria in pregnant women is less frequent. The aim of this study was to provide information of clinical profile, anti-parasite host immune responses and parasite genotyping of pregnant women with malaria in low endemic areas of Colombia.MethodsThis was a descriptive study conducted through passive surveillance in 1328 individuals from three endemic areas of Córdoba, Nariño and Chocó departments between 2011 and 2013. Trained physicians confirmed the pregnancy status and recorded clinical and epidemiological information. Haematological parameters, as well as hepatic and renal function, anti-malarial antibodies and parasite genotypes were evaluated.ResultsA total of 582 women presented with malaria infection, 34 of whom were pregnant (5.8 %), and most were infected by Plasmodium falciparum (n = 24). In 44 % (n = 15) of the women, the infection occurred during the first half of pregnancy. Although uncomplicated disease and parasitaemia ≤20,000 parasites/µL were common (n = 31), three women (8.8 %) infected by P. falciparum were classified as severe cases. Mild to moderate anaemia (68 %) and mild thrombocytopaenia (41 %) were the most frequent blood alterations and in four women acute renal failure was observed. Six women presented a second malaria episode during pregnancy mainly caused by P. vivax (n = 5), although no direct evidence of relapse was found by genotyping. Two out of the six women presenting a second malaria episode had severe malaria. A low prevalence of specific anti-parasite antibodies was found. Microsatellites indicated that all P. vivax infections involved multiple lineages whereas all but one P. falciparum infections harboured single genotypes.ConclusionsMost malaria infected pregnant women displayed uncomplicated malaria, although a few of them with a second malaria episode presented an increased risk of severe malaria which appeared to be associated with malaria transmission intensity and not with levels of anti-parasite antibodies. The effects of severe malaria in both mother and fetus warrant future studies in low transmission settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1125-9) contains supplementary material, which is available to authorized users.

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“…Since the intensity of P. falciparum transmission in Colombia is low, malaria during pregnancy, including placental malaria, occurs infrequently (6)(7)(8). It was therefore highly unexpected when Gnidehou et al (9) reported high levels and frequencies (50 to 70%) of VAR2CSA-specific IgG in Colombia, not only in pregnant women with or without malaria infection but also among nulligravidae, men, and children living in areas of the country where malaria is endemic.…”

mentioning

confidence: 99%

mSphere of Influence: Going Native, or the Risk of Overreliance on Recombinant Antigens

Lopez-Perez

2020

mSphere

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Mary Lopez-Perez works on immunology and pathogenesis of malaria. In this mSphere of Influence article, she reflects on how the paper “Functional antibodies against VAR2CSA in nonpregnant populations from Colombia exposed to Plasmodium falciparum and Plasmodium vivax” by S. Gnidehou, J. Doritchamou, E. M. Arango, A. Cabrera, et al. (Infect Immun 82:2565−2573, 2014, https://doi.org/10.1128/IAI.01594-14) made her cautious of relying exclusively on recombinant proteins when evaluating antibody responses.

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Maternal Clinical Findings in Malaria in Pregnancy in a Region of Northwestern Colombia

Cited by 20 publications

References 18 publications

A descriptive study of 16 severe Plasmodium vivax cases from three municipalities of Colombia between 2009 and 2013

A descriptive study of 16 severe Plasmodium vivax cases from three municipalities of Colombia between 2009 and 2013

Malaria in pregnancy: a passive surveillance study of pregnant women in low transmission areas of Colombia, Latin America

mSphere of Influence: Going Native, or the Risk of Overreliance on Recombinant Antigens

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