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A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement
BACKGROUND & OBJECTIVES: Classically associated with Plasmodium (P.) falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign P. vivax for causing severe malaria as well. We aimed to analy...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Università Cattolica del Sacro Cuore
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224813/ https://www.ncbi.nlm.nih.gov/pubmed/28101311 http://dx.doi.org/10.4084/MJHID.2017.006 |
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author | Ahmad, Sohaib Shirazi, Nadia Bhat, Nowneet K Dhar, Minakshi Mittal, Garima Mittal, Manish Kaeley, Nidhi Kumar, Manoj |
author_facet | Ahmad, Sohaib Shirazi, Nadia Bhat, Nowneet K Dhar, Minakshi Mittal, Garima Mittal, Manish Kaeley, Nidhi Kumar, Manoj |
author_sort | Ahmad, Sohaib |
collection | PubMed |
description | BACKGROUND & OBJECTIVES: Classically associated with Plasmodium (P.) falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign P. vivax for causing severe malaria as well. We aimed to analyse the cerebral complications in malaria, and study if there is a species-related difference in the presentation and outcomes. METHODS: We retrospectively compared patients with malaria hospitalised from 2009–15, with (n=105) and without (n=1155) neurological involvement regarding outcomes, complications, demographic attributes, clinical features, and laboratory parameters. Subsequently, the same parameters were studied in those with cerebral malaria due to mono-infections of P. vivax or P. falciparum and their co-infection. RESULTS: Cerebral malaria was observed in 8.3% (58/696), 7.4% (38/513) and 17.6% (6/51) of P. vivax, P. falciparum and combined plasmodial infections respectively. Those with cerebral malaria had significantly (p<0.05) longer hospitalisation, delayed defervescence, required mechanical ventilatory support and dialysis despite comparable levels of azotemia and renal insufficiency, and adverse outcomes compared to non-cerebral malaria. Severe thrombocytopenia, respiratory distress and mechanical ventilation were significantly (p<0.05) associated with P. vivax cerebral malaria. CONCLUSIONS: The plasmodial species are comparable in clinical and laboratory parameters and outcomes in cerebral malaria in isolation and combination (p>0.05). P. vivax is emerging as the predominant cause of cerebral malaria, and its virulence is comparable to P. falciparum. |
format | Online Article Text |
id | pubmed-5224813 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Università Cattolica del Sacro Cuore |
record_format | MEDLINE/PubMed |
spelling | pubmed-52248132017-01-18 A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement Ahmad, Sohaib Shirazi, Nadia Bhat, Nowneet K Dhar, Minakshi Mittal, Garima Mittal, Manish Kaeley, Nidhi Kumar, Manoj Mediterr J Hematol Infect Dis Original Articles BACKGROUND & OBJECTIVES: Classically associated with Plasmodium (P.) falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign P. vivax for causing severe malaria as well. We aimed to analyse the cerebral complications in malaria, and study if there is a species-related difference in the presentation and outcomes. METHODS: We retrospectively compared patients with malaria hospitalised from 2009–15, with (n=105) and without (n=1155) neurological involvement regarding outcomes, complications, demographic attributes, clinical features, and laboratory parameters. Subsequently, the same parameters were studied in those with cerebral malaria due to mono-infections of P. vivax or P. falciparum and their co-infection. RESULTS: Cerebral malaria was observed in 8.3% (58/696), 7.4% (38/513) and 17.6% (6/51) of P. vivax, P. falciparum and combined plasmodial infections respectively. Those with cerebral malaria had significantly (p<0.05) longer hospitalisation, delayed defervescence, required mechanical ventilatory support and dialysis despite comparable levels of azotemia and renal insufficiency, and adverse outcomes compared to non-cerebral malaria. Severe thrombocytopenia, respiratory distress and mechanical ventilation were significantly (p<0.05) associated with P. vivax cerebral malaria. CONCLUSIONS: The plasmodial species are comparable in clinical and laboratory parameters and outcomes in cerebral malaria in isolation and combination (p>0.05). P. vivax is emerging as the predominant cause of cerebral malaria, and its virulence is comparable to P. falciparum. Università Cattolica del Sacro Cuore 2017-01-01 /pmc/articles/PMC5224813/ /pubmed/28101311 http://dx.doi.org/10.4084/MJHID.2017.006 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Ahmad, Sohaib Shirazi, Nadia Bhat, Nowneet K Dhar, Minakshi Mittal, Garima Mittal, Manish Kaeley, Nidhi Kumar, Manoj A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement |
title | A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement |
title_full | A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement |
title_fullStr | A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement |
title_full_unstemmed | A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement |
title_short | A Hospital-Based Retrospective Comparative Study of Complications, Outcomes, Clinical and Laboratory Parameters of Malaria with and without Neurological Involvement |
title_sort | hospital-based retrospective comparative study of complications, outcomes, clinical and laboratory parameters of malaria with and without neurological involvement |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224813/ https://www.ncbi.nlm.nih.gov/pubmed/28101311 http://dx.doi.org/10.4084/MJHID.2017.006 |
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