Malaria complicada en el Chocó: hallazgos clínicos y comparación de datos con el sistema de vigilancia

Murillo-Palacios, Olga L.; Pedroza, Carmen Enith; Bolaños, Claudia; Toro, Elvis Del; Cubillos, J. Monzó i; Chaparro, Pablo; Mosquera, Miladys

doi:10.15446/rsap.v20n1.50077

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Complications during malaria caused by P. vivax is an increasingly reported phenomenon for which we lack understanding of its etiology [28,29]. Anemia is one of most reported complications associated with P. vivax malaria, but little is understood about the mechanism leading to it [7,30,31].…”

Section: Discussionmentioning

confidence: 99%

Atypical memory B-cells and autoantibodies correlate with anemia during Plasmodium vivax complicated infections

Rivera-Correa¹,

Yasnot²,

Tovar³

et al. 2020

PLoS Negl Trop Dis

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Malaria caused by Plasmodium vivax is a highly prevalent infection worldwide , that was previously considered mild, but complications such as anemia have been highly reported in the past years. In mice models of malaria, anti-phosphatidylserine (anti-PS) autoantibodies, produced by atypical B-cells, bind to uninfected erythrocytes and contribute to anemia. In human patients with P. falciparum malaria, the levels of anti-PS, atypical B-cells and anemia are strongly correlated to each other. In this study, we focused on assessing the relationship between autoantibodies, different B-cell populations and hemoglobin levels in two different cohorts of P. vivax patients from Colombia, South America. In a first longitudinal cohort, our results show a strong inverse correlation between different IgG autoantibodies tested (anti-PS, anti-DNA and anti-erythrocyte) and atypical memory B-cells (atMBCs) with hemoglobin in both P. vivax and P. falciparum patients over time. In a second cross-sectional cohort, we observed a stronger relation between hemoglobin levels, atMBCs and autoantibodies in complicated P. vivax patients compared to uncomplicated ones. Altogether, these data constitute the first evidence of autoimmunity associating with anemia and complicated P. vivax infections, suggesting a role for its etiology through the expansion of autoantibody-secreting atMBCs.

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Section: Discussionmentioning

confidence: 99%

Atypical memory B-cells and autoantibodies correlate with anemia during Plasmodium vivax complicated infections

Rivera-Correa¹,

Yasnot²,

Tovar³

et al. 2020

PLoS Negl Trop Dis

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“…Of these totals, 40 000 cases per year were in Chocó, amounting to 8- to 10-fold annual rate increases from previous years. 71 The reasons for the increases are unknown. However, Chocó is the second largest gold-producing state in Colombia (behind Antioquia) and is also where deforestation is occurring faster than elsewhere.…”

Section: Diagnosismentioning

confidence: 99%

Disarmament is the New War, Gold is the New Opium, and Ecohealth is the Historic Victim

Villar

Schaeffer

2019

Environ�Health�Insights

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In Colombia, the convergence of drug trafficking, illegal armed groups, and gold production and trade threatens peace and stability in the post-FARC (Revolutionary Armed Forces of Colombia) era, as had the narcotics trade previously. Armed groups and criminal organizations have increased and consolidated their influence over illegal mining and may be diverting US$5 billion from Colombia’s annual economy. As of 2014, 46% of the total area (78 939 ha) exploited for alluvial gold was in the Afro-Colombian Pacific States, in which unregulated mining was the main driver of deforestation. The informal job market represents 49% of the workforce and absent other economic alternatives, this workforce of ex-guerrillas, organized crime groups and corrupt officials will sustain the black markets that permeate gold mining. Human health consequences of unregulated gold mining are largely unrecognized, but include the spread of malaria and other insect-borne diseases, and we suggest diseases such as babesiosis.

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“…In turn, low parasite density thresholds were observed in the Pacific Coast and Upper Sinú-San Jorge-Lower Cauca-Middle Urabá-Magdalena regions. These regions are historical endemic foci whose exposed population may have some degree of immunity to the disease, which could explain the low parasitemia, in addition to better access to diagnosis and treatment [31,32].…”

Section: Plos Onementioning

confidence: 99%

Parasite density in severe malaria in Colombia

Padilla-Rodríguez¹,

Olivera²,

Guevara-García³

2020

PLoS ONE

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Background Colombia has officially adopted the parasite density levels of severe malaria established by the WHO (>50,000 parasites/μl). These values have been inferred from areas of high transmission in Africa and are not consistent with the dynamics of low and unstable transmission in Colombia. The objective of this study was therefore to determine the parasite density values observed in patients with severe malaria and their distribution in the different ecoepidemiological regions of Colombia. Methods A retrospective and descriptive study of confirmed cases of severe malaria was conducted in endemic areas of malaria in Colombia over the period 2014-2017. Data were collected from secondary sources of the Subnational Programs of Malaria Prevention and Control. Person, place, and time variables were selected. The official definition of severe malaria was adopted, and compliance with these criteria was determined. Univariate and bivariate analyses were conducted with absolute and relative frequency measures, and the relevant statistical tests were applied. Results The overall parasite density values in Colombia showed a geometric mean of 5,919 parasites/μl (95% CI: 5,608-6,248). By parasite species, the values were 6,151 (95% CI: 5,631-6,718) for Plasmodium falciparum and 5,815 (95% CI: 5,428-6,230) for Plasmodium vivax. The highest parasite density values were recorded in the Amazon ecoepidemiological region (8,177; 95% CI: 6,015-11,116), and the lowest values were recorded in the Andean region (5,026; 95% CI: 2,409-10,480). Conclusions In endemic areas of low and unstable malaria transmission in the Colombian territory, the parasite density levels observed in populations with severe malaria are lower than the officially established values. The parasite density criterion is not really a relevant criterion for the definition of severe cases in Colombia and it certainly not be used to make a clinical decision about the severity of the disease.

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Malaria complicada en el Chocó: hallazgos clínicos y comparación de datos con el sistema de vigilancia

Cited by 4 publications

References 13 publications

Atypical memory B-cells and autoantibodies correlate with anemia during Plasmodium vivax complicated infections

Atypical memory B-cells and autoantibodies correlate with anemia during Plasmodium vivax complicated infections

Disarmament is the New War, Gold is the New Opium, and Ecohealth is the Historic Victim

Parasite density in severe malaria in Colombia

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