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Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon

BACKGROUND: Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs) in the Wester...

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Autores principales: Lança, Ellen Fátima Caetano, Magalhães, Belisa Maria Lopes, Vitor-Silva, Sheila, Siqueira, André Machado, Benzecry, Silvana Gomes, Alexandre, Márcia Almeida Araújo, O'Brien, Connor, Bassat, Quique, Lacerda, Marcus Vinícius Guimarães
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327677/
https://www.ncbi.nlm.nih.gov/pubmed/22523591
http://dx.doi.org/10.1371/journal.pone.0035406
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author Lança, Ellen Fátima Caetano
Magalhães, Belisa Maria Lopes
Vitor-Silva, Sheila
Siqueira, André Machado
Benzecry, Silvana Gomes
Alexandre, Márcia Almeida Araújo
O'Brien, Connor
Bassat, Quique
Lacerda, Marcus Vinícius Guimarães
author_facet Lança, Ellen Fátima Caetano
Magalhães, Belisa Maria Lopes
Vitor-Silva, Sheila
Siqueira, André Machado
Benzecry, Silvana Gomes
Alexandre, Márcia Almeida Araújo
O'Brien, Connor
Bassat, Quique
Lacerda, Marcus Vinícius Guimarães
author_sort Lança, Ellen Fátima Caetano
collection PubMed
description BACKGROUND: Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs) in the Western Brazilian Amazon, and to identify risk factors associated with disease severity. METHODS AND FINDINGS: In this retrospective study, clinical records of 34 children, 0–14 years of age hospitalized in the 11 public pediatric and neonatal ICUs of the Manaus area, were reviewed. P. falciparum monoinfection or P. falciparum/P. vivax mixed infection was diagnosed by microscopy in 10 cases, while P. vivax monoinfection was confirmed in the remaining 24 cases. Two of the 24 patients with P. vivax monoinfection died. Respiratory distress, shock and severe anemia were the most frequent complications associated with P. vivax infection. Ninety-one children hospitalized with P. vivax monoinfections but not requiring ICU were consecutively recruited in a tertiary care hospital for infectious diseases to serve as a reference population (comparators). Male sex (p = 0.039), age less than five years (p = 0.028), parasitemia greater than 500/mm(3) (p = 0.018), and the presence of any acute (p = 0.023) or chronic (p = 0.017) co-morbidity were independently associated with ICU admission. At least one of the WHO severity criteria for malaria (formerly validated for P. falciparum) was present in 23/24 (95.8%) of the patients admitted to the ICU and in 17/91 (18.7%) of controls, making these criteria a good predictor of ICU admission (p = 0.001). The only investigated criterion not associated with ICU admission was hyperbilirubinemia (p = 0.513)]. CONCLUSIONS: Our study points to the importance of P. vivax-associated severe disease in children, causing 72.5% of the malaria admissions to pediatric ICUs. WHO severity criteria demonstrated good sensitivity in predicting severe P. vivax infection in this small case series.
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spelling pubmed-33276772012-04-20 Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon Lança, Ellen Fátima Caetano Magalhães, Belisa Maria Lopes Vitor-Silva, Sheila Siqueira, André Machado Benzecry, Silvana Gomes Alexandre, Márcia Almeida Araújo O'Brien, Connor Bassat, Quique Lacerda, Marcus Vinícius Guimarães PLoS One Research Article BACKGROUND: Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs) in the Western Brazilian Amazon, and to identify risk factors associated with disease severity. METHODS AND FINDINGS: In this retrospective study, clinical records of 34 children, 0–14 years of age hospitalized in the 11 public pediatric and neonatal ICUs of the Manaus area, were reviewed. P. falciparum monoinfection or P. falciparum/P. vivax mixed infection was diagnosed by microscopy in 10 cases, while P. vivax monoinfection was confirmed in the remaining 24 cases. Two of the 24 patients with P. vivax monoinfection died. Respiratory distress, shock and severe anemia were the most frequent complications associated with P. vivax infection. Ninety-one children hospitalized with P. vivax monoinfections but not requiring ICU were consecutively recruited in a tertiary care hospital for infectious diseases to serve as a reference population (comparators). Male sex (p = 0.039), age less than five years (p = 0.028), parasitemia greater than 500/mm(3) (p = 0.018), and the presence of any acute (p = 0.023) or chronic (p = 0.017) co-morbidity were independently associated with ICU admission. At least one of the WHO severity criteria for malaria (formerly validated for P. falciparum) was present in 23/24 (95.8%) of the patients admitted to the ICU and in 17/91 (18.7%) of controls, making these criteria a good predictor of ICU admission (p = 0.001). The only investigated criterion not associated with ICU admission was hyperbilirubinemia (p = 0.513)]. CONCLUSIONS: Our study points to the importance of P. vivax-associated severe disease in children, causing 72.5% of the malaria admissions to pediatric ICUs. WHO severity criteria demonstrated good sensitivity in predicting severe P. vivax infection in this small case series. Public Library of Science 2012-04-16 /pmc/articles/PMC3327677/ /pubmed/22523591 http://dx.doi.org/10.1371/journal.pone.0035406 Text en Lança et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Lança, Ellen Fátima Caetano
Magalhães, Belisa Maria Lopes
Vitor-Silva, Sheila
Siqueira, André Machado
Benzecry, Silvana Gomes
Alexandre, Márcia Almeida Araújo
O'Brien, Connor
Bassat, Quique
Lacerda, Marcus Vinícius Guimarães
Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon
title Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon
title_full Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon
title_fullStr Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon
title_full_unstemmed Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon
title_short Risk Factors and Characterization of Plasmodium Vivax-Associated Admissions to Pediatric Intensive Care Units in the Brazilian Amazon
title_sort risk factors and characterization of plasmodium vivax-associated admissions to pediatric intensive care units in the brazilian amazon
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327677/
https://www.ncbi.nlm.nih.gov/pubmed/22523591
http://dx.doi.org/10.1371/journal.pone.0035406
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