Dynamics of Plasmodium falciparum Parasitemia Regarding Combined Treatment Regimens for Acute Uncomplicated Malaria, Antioquia, Colombia

Álvarez, Gonzalo; Tobón, Alberto; Piñeros, Juan Gabriel; Ríos, Alexandra; Blair, Silvia

doi:10.4269/ajtmh.2010.09-0286

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…Los antipalúdicos suministrados han mostrado excelente eficacia terapéutica en el país, cloroquina para P. vivax (cloroquina) (21) y artesunato-mefloquina o amodiaquinasulfadoxinapirimetamina para P. falciparum (22), observándose mejoría clínica y cura parasitológica el día 3 después de iniciado el tratamiento, con ausencia de cuadros clínicos complicados, lo que coincide con este estudio.…”

Section: Discussionunclassified

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

2012

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“…A total of 257 P. falciparum blood samples collected on filter paper between 2002 and 2009 from surveillance studies carried out in Turbo (Antioquia department, Colombia) were genotyped: 94 samples were collected between October 2002 and July 2003, 80 from January 2004 to December 2005, 47 between April and October 2007, and 36 between March 2008 and July 2009. All samples came from P. falciparum -positive patients diagnosed by blood smear that gave their consent to participate in therapeutic efficacy studies at their local hospital [ 14 , 18 ]. The samples used were those collected prior treatment [ 14 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…All samples came from P. falciparum -positive patients diagnosed by blood smear that gave their consent to participate in therapeutic efficacy studies at their local hospital [ 14 , 18 ]. The samples used were those collected prior treatment [ 14 , 18 ]. The inclusion criteria for the participants were: (a) patients that were older than 1 year of age with fever that lasted 48 h, (b) the patients were living permanently in the study site, and (c) none had severe malaria or were pregnant.…”

Section: Methodsmentioning

confidence: 99%

Longitudinal analysis of Plasmodium falciparum genetic variation in Turbo, Colombia: implications for malaria control and elimination

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Taylor

Blair

et al. 2015

Malar J

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BackgroundMalaria programmes estimate changes in prevalence to evaluate their efficacy. In this study, parasite genetic data was used to explore how the demography of the parasite population can inform about the processes driving variation in prevalence. In particular, how changes in treatment and population movement have affected malaria prevalence in an area with seasonal malaria.MethodsSamples of Plasmodium falciparum collected over 8 years from a population in Turbo, Colombia were genotyped at nine microsatellite loci and three drug-resistance loci. These data were analysed using several population genetic methods to detect changes in parasite genetic diversity and population structure. In addition, a coalescent-based method was used to estimate substitution rates at the microsatellite loci.ResultsThe estimated mean microsatellite substitution rates varied between 5.35 × 10−3 and 3.77 × 10−2 substitutions/locus/month. Cluster analysis identified six distinct parasite clusters, five of which persisted for the full duration of the study. However, the frequencies of the clusters varied significantly between years, consistent with a small effective population size.ConclusionsMalaria control programmes can detect re-introductions and changes in transmission using rapidly evolving microsatellite loci. In this population, the steadily decreasing diversity and the relatively constant effective population size suggest that an increase in malaria prevalence from 2004 to 2007 was primarily driven by local rather than imported cases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0887-9) contains supplementary material, which is available to authorized users.

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“…Nos demais países os casos autóctones registrados estão relacionados com a migração sazonal e com as lacunas deixadas no controle vetorial (JURI et al, 2009;ALVAREZ et al, 2010).…”

Section: Epidemiologia Da Malária No Mundounclassified

Malária em gestantes no município de Cruzeiro do Sul pertencente à região amazônica brasileira

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Dynamics of Plasmodium falciparum Parasitemia Regarding Combined Treatment Regimens for Acute Uncomplicated Malaria, Antioquia, Colombia

Cited by 8 publications

References 22 publications

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

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

Longitudinal analysis of Plasmodium falciparum genetic variation in Turbo, Colombia: implications for malaria control and elimination

Malária em gestantes no município de Cruzeiro do Sul pertencente à região amazônica brasileira

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