Paludismo importado en adultos. Perfil clínico, epidemiológico y analítico

Ramírez‐Olivencia, Germán; Herrero, María Dolores; Subirats, Mercedes; Juanes, J.R. de; Peña, José M.; Puente, Sabino

doi:10.1016/j.rce.2011.07.017

Cited by 13 publications

(12 citation statements)

References 25 publications

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“…83% (30/36 studies) reported a hypocholesterolaemia in patients with malaria or a significantly lowered total cholesterol level compared to the control group. Two studies reported a raised cholesterol [36,41], three studies showed no significant differences with the control group [9,39,43] and one study was inconclusive [48] (see Additional file 7: Table S1 for details). Forest plot 1 (n = 15) (Figure 2) shows the mean difference for cholesterol in malaria patients versus healthy controls: 1.09 mmol/l or 42.15 mg/dl (95% CI 0.74-1.44 mmol/l), I 2 = 98%, Z = 6.14 P < 0.00001.…”

Section: Resultsmentioning

confidence: 99%

Serum lipids and lipoproteins in malaria - a systematic review and meta-analysis

Visser

Wieten

Nagel

et al. 2013

Malar J

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BackgroundSerum lipid profile changes have been observed during malaria infection. The underlying biological mechanisms remain unclear. The aim of this paper is to provide an overview on those serum lipid profile changes, and to discuss possible underlying biological mechanisms and the role of lipids in malaria pathogenesis.MethodsA systematic review and meta-analysis to determine lipid profile changes during malaria was conducted, following PRISMA guidelines. Without language restrictions, Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, Biosis Previews and the African Index Medicus were searched for studies published up to 11 July, 2013, that measured serum lipid parameters in malaria patients. Also, major trial registries were searched. Mean differences in lipid profile parameters were combined in fixed and random effects meta-analysis, with a separate analysis for different groups of controls (healthy, other febrile illnesses or very low parasitaemia). These parameters were also compared between severe malaria and uncomplicated malaria. Funnel plots were used to test for publication bias.ResultsOf 2,518 studies reviewed, 42 met the criteria for inclusion in the qualitative analysis, and of these, 15 reported the necessary data for inclusion in the meta-analysis for cholesterol; nine for high-density lipoprotein (HDL), eight for low-density lipoprotein (LDL), and nine for triglycerides, respectively. Total cholesterol, HDL and LDL concentrations were lower in malaria and other febrile diseases compared to healthy controls. The decline was more pronounced and statistically significant during malaria compared to other febrile diseases. These results were consistent across included studies. Triglycerides were raised compared to healthy controls, but not statistically significant when compared to symptomatic controls.ConclusionsThis meta-analysis suggests that the observed lipid profile changes are characteristic for malaria. Although a definite link with the pathogenesis of malaria cannot yet be demonstrated, plausible hypotheses of biological mechanisms involving host lipid alterations and the pathogenesis of malaria exist. An increased research effort to elucidate the precise pathways is warranted, since this could lead to better understanding of malaria pathophysiology and consequently to novel treatment approaches.

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Section: Resultsmentioning

confidence: 99%

Serum lipids and lipoproteins in malaria - a systematic review and meta-analysis

Visser

Wieten

Nagel

et al. 2013

Malar J

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“…Infection of semi-immune persons is common in endemic countries, as previously mentioned, and has also been described in immigrants [18,24]. Another explanation can be the development of resistance to anti-malarial treatment, as a result of an incorrect management of the treatment or caused by low levels of medication, as well as the “controlled infection¨ in people taking anti-malarial chemoprophylaxis.…”

Section: Discussionmentioning

confidence: 99%

“…Cases of malaria were allocated into four groups following the classification criteria published by our study group [18,19]: natives, native-travellers, residents, and travellers. Natives are persons born and living in zones endemic for malaria, that come to a non-endemic zone.…”

Section: Methodsmentioning

confidence: 99%

Imported submicroscopic malaria in Madrid

Ramírez‐Olivencia

Rubio

Rivas

et al. 2012

Malar J

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BackgroundSubmicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM.The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM.MethodsA retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia.ResultsSMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%).ConclusionsResults from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously described in endemic zones, and presence of vector in Europe has also been reported. Implementation of molecular tests in all asymptomatic individuals coming from endemic area is not economically feasible. So re-emergence of malaria (Plasmodium vivax) in Europe may be speculated.

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“…Un total de 15 estudios describían las características de los casos de malaria importada en inmigrantes 3,[9][10][11][28][29][30][31][32][33][34][35][36][37][38] . La mayor parte procedían del África Subsahariana (85-96%), seguido de Asia (3-13%) y Latinoamérica (0,5-8,7%) siendo P. falciparum la especie más frecuente (55-94%), seguido de P.vivax (2-30%)que fue la espe-cie más frecuente en los inmigrantes de América Latina (71%) y Asia (69%) 31,32 .…”

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