Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

Malaria Journal

Review

Patrícia Brasil¹  Franklin S Santana Filho²  Belisa ML Magalhães²  André M Siqueira²  Flor E Martinez-Espinosa³  Maria GC Alecrim⁴  Maria PG Mourão⁴  Marcus VG Lacerda⁴  Márcia AA Alexandre⁴  Ana MRS Ventura⁵  Mauro S Tada⁶  Vanja SCD Couto⁷  Rita SU Silva⁸  Antônio R Silva⁹ 

[1] Fundação Oswaldo Cruz, Av. Brasil, 4365, 21040-360, Rio de Janeiro, Brazil;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, 69040-000, Manaus Amazonas, Brazil;Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, 69040-000, Manaus Amazonas, Brazil;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, 69040-000, Manaus Amazonas, Brazil;Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, 69040-000, Manaus Amazonas, Brazil;Instituto Leônidas e Maria Deane, FIOCRUZ Amazônia, R. Terezina, 476, 69057-070, Manaus Amazonas, Brazil;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, 69040-000, Manaus Amazonas, Brazil;Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, 69040-000, Manaus Amazonas, Brazil;Universidade Nilton Lins, Av. Prof. Nilton Lins, 3259, 69058-040, Manaus Amazonas, Brazil;Instituto Evandro Chagas, Rodovia BR-316 km 7 s/n, 67030-000, Ananindeua, Brazil;Instituto de Pesquisas em Patologias Tropicais, R. da Beira, 7671, Rodovia BR-360 km 3, Porto Velho, Rondônia, Brazil;Secretaria de Saúde do Amapá, Av. FAB, 69, 68.900-000, Macapá, Amapá, Brazil;Universidade Federal do Acre, Rodovia BR-364 km 4, 6637, 69915-900, Rio Branco Acre, Brazil;Universidade Federal do Maranhão, Praça Madre Deus 2, 65025-560, São Luiz Maranhão, Brazil;

关键词: Malaria;    Plasmodium vivax;    Brazil;    Severity;    Clinical aspects;    Anaemia;    Systematic review;   

DOI  :  10.1186/1475-2875-11-12

 received in 2011-10-20, accepted in 2012-01-09,  发布年份 2012

来源: Springer

【 摘 要 】

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out.

【 授权许可】

CC BY   
© Lacerda et al; licensee BioMed Central Ltd. 2011