Haemoglobinuria among children with severe malaria attending tertiary care in Ibadan, Nigeria

Ajetunmobi, Wasiu A.; Orimadegun, Adebola E.; Bj, Brown; Afolabi, Nathaniel K.; Olabiyi, Folorunso Adewale; Anetor, John I; Omokhodion, Samuel; Osinusi, K; Akinbami, Felix O.; Shokunbi, Wuraola A.; Sodeinde, Olugbemiro; Fernández-Reyes, Delmiro

doi:10.1186/1475-2875-11-336

Cited by 34 publications

(43 citation statements)

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“…One patient developed respiratory failure due to complicated P. vivax malaria, a finding previously reported in other Brazilian studies [31,32]. Six patients with P. vivax malaria presented with haemoglobinuria (4% of P. vivax cases), a rate of incidence similar to what has been observed previously in a multicenter study of endemic areas [33], but the proportions may vary [34] and previous studies on this topic focused on P. falciparum malaria.…”

Section: Discussionsupporting

confidence: 76%

Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast

Dos-Santos

Angerami

Castiñeiras

et al. 2014

Malar J

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BackgroundAlthough malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject.MethodsA retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011.ResultsAmongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections.ConclusionsSevere malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment.

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Section: Discussionsupporting

confidence: 76%

Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast

Dos-Santos

Angerami

Castiñeiras

et al. 2014

Malar J

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“…All participating children from Ibadan were recruited under the direction of the Childhood Malaria Research Group (CMRG) at the Department of Pediatrics of the University College Hospital (UCH), Ibadan, Nigeria, as previously described (8)(9)(10)(11). Briefly, children were 6 months to 13 years of age.…”

Section: Methodsmentioning

confidence: 99%

The IL17F and IL17RA Genetic Variants Increase Risk of Cerebral Malaria in Two African Populations

et al. 2016

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jCerebral malaria (CM) is a neurological complication of infection with Plasmodium falciparum that is partly caused by cytokine-mediated inflammation. It is not known whether interleukin-17 (IL-17) cytokines, which regulate inflammation, control the development of CM. To evaluate the involvement of IL-17 cytokines in CM, we analyzed 46 common polymorphisms in IL17A, IL17F, and IL17RA (which encodes the common receptor chain of the members of the IL-17 family) in two independent African populations. A case-control study involving 115 Nigerian children with CM and 160 controls from the community (CC) showed that IL17F reference single nucleotide polymorphism (SNP) 6913472 (rs6913472) (P ‫؍‬ 0.004; odds ratio [OR] ‫؍‬ 3.12), IL17F rs4715291 (P ‫؍‬ 0.004; OR ‫؍‬ 2.82), IL17RA rs12159217 (P ‫؍‬ 0.01; OR ‫؍‬ 2.27), and IL17RA rs41396547 (P ‫؍‬ 0.026; OR ‫؍‬ 3.15) were independently associated with CM. A replication study was performed in 240 nuclear Malian family trios (two parents with one CM child). We replicated the association for 3 SNPs, IL17F rs6913472 (P ‫؍‬ 0.03; OR ‫؍‬ 1.39), IL17RA rs12159217 (P ‫؍‬ 0.01; OR ‫؍‬ 1.52), and IL17RA rs41396547 (P ‫؍‬ 0.04; OR ‫؍‬ 3.50). We also found that one additional SNP, IL17RA rs41433045, in linkage disequilibrium (LD) with rs41396547, was associated with CM in both Nigeria and Mali (P ‫؍‬ 0.002; OR ‫؍‬ 4.12 in the combined sample). We excluded the possibility that SNPs outside IL17F and IL17RA, in strong LD with the associated SNPs, could account for the observed associations. Furthermore, the results of a functional study indicated that the aggravating GA genotype of IL17F rs6913472 was associated with lower IL-17F concentrations. Our findings show for the first time that IL17F and IL17RA polymorphisms modulate susceptibility to CM and provide evidence that IL-17F protects against CM. C erebral malaria (CM) is one of the most severe complications of infection with Plasmodium falciparum and occurs predominantly in young children under 5 years of age and in "nonimmune" adults. The clinical characteristics of CM are an unarousable coma lasting for at least 1 h, with or without generalized convulsions, and asexual P. falciparum parasitemia with normal cerebrospinal fluid and no other cause of encephalopathy. This reversible encephalopathy is characterized by the sequestration of infected red blood cells (IRBC) in the capillaries of the brain together with the accumulation of leukocytes, platelets, and uninfected red blood cells (URBC) causing mechanical obstruction of microvessels and excessive activation of immune cells. Other pathological consequences are brain edema, alterations of the integrity of the blood-brain barrier (BBB), microhemorrhages, and tissue necrosis (1). However, despite the large number of studies that have investigated CM, the orchestration of the pathogenic mechanisms leading to CM is not well understood.Proinflammatory cytokines are thought to contribute to brain pathology in CM. Interleukin-17A (IL-17A) and IL-17F, the best-studied members of the IL-...

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“…In Vietnam, in a case series of semi-immune adults with BWF, in which only 32% had concurrent P. falciparum malaria infection, aetiological factors included quinine treatment (56%) and G6PD deficiency (54%) [97]. In Africa, recent publications describing case-series of BWF tend to be from regions where children are exposed to intense P. falciparum malaria transmission (Nigeria, Democratic Republic of Congo (DRC), and Uganda) [98-100]. In a case-control study conducted in the DRC, the majority (88.4%) of BWF cases occurred in the rainy season when BWF was apparently more likely to be related to quinine pre-treatment.…”

Section: Introductionmentioning

confidence: 99%

Management of severe paediatric malaria in resource-limited settings

Maitland

2015

BMC Med

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Over 90% of the world’s severe and fatal Plasmodium falciparum malaria is estimated to affect young children in sub-Sahara Africa, where it remains a common cause of hospital admission and inpatient mortality. Few children will ever be managed on high dependency or intensive care units and, therefore, rely on simple supportive treatments and parenteral anti-malarials. There has been some progress on defining best practice for antimalarial treatment with the publication of the AQUAMAT trial in 2010, involving 5,425 children at 11 centres across 9 African countries, showing that in artesunate-treated children, the relative risk of death was 22.5% (95% confidence interval (CI) 8.1 to 36.9) lower than in those receiving quinine. Human trials of supportive therapies carried out on the basis of pathophysiology studies, have so far made little progress on reducing mortality; despite appearing to reduce morbidity endpoints, more often than not they have led to an excess of adverse outcomes. This review highlights the spectrum of complications in African children with severe malaria, the therapeutic challenges of managing these in resource-poor settings and examines in-depth the results from clinical trials with a view to identifying the treatment priorities and a future research agenda.

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Haemoglobinuria among children with severe malaria attending tertiary care in Ibadan, Nigeria

Cited by 34 publications

References 30 publications

Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast

Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast

The IL17F and IL17RA Genetic Variants Increase Risk of Cerebral Malaria in Two African Populations

Management of severe paediatric malaria in resource-limited settings

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