The epidemiology of severe malaria in an area of low transmission in Thailand

Luxemburger, Christine; Ricci, Françoise; Nosten, François; Raimond, Dominique; Bathet, Saw; White, Nicholas J.

doi:10.1016/s0035-9203(97)90066-3

Cited by 253 publications

(231 citation statements)

References 22 publications

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“…During this period, inhabitants of these villages have, over the years, been subjected to different antimalarial strategies under NAMP. The available data indicate that the burden of malaria morbidity is very high in this community, as reported earlier from Thailand in areas under the influence of both P. vivax and P. falciparum (Luxemburger et al 1997); however, mortality is very low. Measuring mortality from malaria is difficult as there is no system of routine death certification.…”

Section: Discussionsupporting

confidence: 73%

Changing scenario of malaria in central India, the replacement of Plasmodium vivax by Plasmodium falciparum (1986–2000)

Singh

Nagpal

Saxena

et al. 2004

Tropical Med Int Health

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Summaryobjectives Since 1986, we have been studying the changing epidemiology of malaria in a forest belt of Mandla, which has the highest number of malaria cases in central India (Madhya Pradesh) to define the epidemiological characteristics of the infection with each Plasmodium species in different seasons of the year. Our long-term objective was to determine the dynamics of Plasmodium vivax vs. P. falciparum infections.methods Five villages underwent fortnightly surveillance of fever cases. Drugs were distributed within 24 h after results of blood smears became available as per Indian National Anti-Malaria Programme. Indoor resting mosquitoes were also collected fortnightly.results The only two Plasmodium species encountered were P. vivax and P. falciparum in both children and adults. Relatively more malaria infections were recorded in children (£14 years) than adults (>14 years) (v 2 ¼ 89.94, P < 0.00001). However, there were significant falling trends in P. vivax from 1986 to 2000 in both age groups (£14 years from 63 to 13, P < 0.0001 and >14 years from 84 to 7, P < 0.0001). The indoor resting density of Anopheles culicifacies, an efficient vector resistant to both dichlorodiphenyltrichloroethane (DDT) (4%) and hexachlorocyclohexane (HCH) (0.4%), was very high throughout this period in all villages (52.35 ± 31.8, range 5-200 per man hour).Anopheles fluviatilis was present in small numbers 0.78 ± 1.24 (range 0-7 per man hour).conclusion Major contributors of the changing epidemiology of malaria in this area are changing drug sensitivity along with insecticide sensitivity.

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Section: Discussionsupporting

confidence: 73%

Changing scenario of malaria in central India, the replacement of Plasmodium vivax by Plasmodium falciparum (1986–2000)

Singh

Nagpal

Saxena

et al. 2004

Tropical Med Int Health

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“…However, risk of severe disease among adults in populations with chronic exposure to relatively low risk of malaria, e.g. along the Thai-Burma border [39] or in urban areas of Sub-Saharan Africa [40], tends to be appreciably lower compared to young children. We believe the age-dependent exacerbation of risk of severe disease may appear only in adults and children who are not chronically exposed to infection by P. falciparum.…”

Section: Discussionmentioning

confidence: 99%

Adult Javanese migrants to Indonesian Papua at high risk of severe disease caused by malaria

Baird¹,

Basri

Weina³

et al. 2003

Epidemiol. Infect.

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Migrants from Java arrive in hyperendemic Papua, Indonesia lacking exposure to endemic malaria. We evaluated records of evacuation to hospital with a diagnosis of severe malaria from a transmigration village in northeastern Papua. During the first 30 months, 198 residents with severe disease were evacuated (7·5 evacuations/100 person-years). During this period the risk of evacuation for adults (>15 years of age) was 2·8. (95% CI=2·1–3·8; P<0·0001) relative to children, despite apparently equal exposure to risk of infection. Relative risk (RR) for adults was greatest during the first 6 months (RR>16; 95% CI[ges ]2·0–129; P=0·0009), and diminished during the second 6 months (RR=9·4; 95% CI=2·7–32·8; P<0·0001) and the third 6 months (RR=3·7; 95% CI=1·7–7·9; P=0·0004). During the next two 6-month intervals, the RR for adults was 1·6 and 1·5 (95% CI range 0·8–2·6; P<0·18). Adults lacking chronic exposure were far more likely to progress to severe disease compared to children during initial exposure, but not after chronic exposure to infection.

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“…Además, debido a la variabilidad que puede presentarse en la expresión de la enfermedad, se ha recomendado que estos criterios de la OMS sean adaptados a las condiciones epidemiológicas particulares (26). Por lo anterior, estos criterios deben ajustarse en la práctica clínica .…”

Section: Complicaciones Clínicas Diagnosticadas Y Criterios Usadosunclassified

Prognostic value of clinical and parasitological signs for severe malaria in patients from Colombia

2012

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Introducción. El pronto reconocimiento de los signos de peligro en los pacientes con malaria puede reducir las complicaciones y muertes. Sin embargo, se conoce poco sobre su valor pronóstico para la malaria complicada, especialmente en las zonas de transmisión baja e inestable de la enfermedad. Objetivo. Estimar el valor pronóstico de gravedad que tienen diversos signos clínicos y parasitológicos en los pacientes con malaria. Materiales y métodos. Se hizo un estudio en una cohorte prospectiva con pacientes de cinco municipios de Colombia, con diagnóstico de malaria por Plasmodium falciparum y P. vivax, en quienes se estudió la asociación de los signos clínicos y los parasitológicos con la malaria complicada. Resultados. Se obtuvo un modelo de predicción con una sensibilidad de 47,4 % y especificidad de 92,8 %, valor pronóstico positivo de 63,2 % y valor pronóstico negativo de 87,1 %, el cual incluye ictericia, orina oscura, hiperpirexia y signos de deshidratación. Conclusiones. Con el fin de causar un impacto en la morbilidad complicada de la malaria, se propone una estrategia de reconocimiento de los signos de peligro por el personal no médico, que se acompañe de otros elementos de la atención, como el suministro de un tratamiento antipalúdico adecuado y oportuno. Se proponen los criterios del diagnóstico de complicación moderada. Palabras clave: malaria, signos y síntomas, Plasmodium falciparum, Plasmodium vivax. Prognostic value of clinical and parasitological signs for severe malaria in patients from ColombiaIntroduction. Early recognition of danger signs in patients with malaria can reduce complications and deaths, but little is known about their prognostic value for severe malaria, especially in areas of low transmission and unstable malaria. Objective. To assess the prognostic value for severity of different clinical and parasitological signs in patients with malaria. Materials and methods. A prospective cohort of patients from five municipalities in Colombia with diagnosis of Plasmodium falciparum or P. vivax malaria in whom the association between clinical and parasitological signs with complicated malaria was studied. Results. A predictive model with 47.4% sensitivity, 92.8% specificity, 63.2% positive predictive value and 87.1% negative predictive value was obtained which includes jaundice, dark urine, hyperpyrexia and signs of dehydration. Conclusions. To impact the morbidity of complicated proposed a strategy is proposed for the early recognition of danger signs by non-medical personnel, which could be complemented by other elements of health care, such as providing adequate and appropriate antimalarial treatment. Diagnostic criteria for moderate complication are also proposed.

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The epidemiology of severe malaria in an area of low transmission in Thailand

Cited by 253 publications

References 22 publications

Changing scenario of malaria in central India, the replacement of Plasmodium vivax by Plasmodium falciparum (1986–2000)

Changing scenario of malaria in central India, the replacement of Plasmodium vivax by Plasmodium falciparum (1986–2000)

Adult Javanese migrants to Indonesian Papua at high risk of severe disease caused by malaria

Prognostic value of clinical and parasitological signs for severe malaria in patients from Colombia

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