Retinopathy of vivax malaria in adults and its relation with severity parameters

Kochar, Anju; Kalra, Paavan; Sb,; Ukirade,; Chahar, A.; Dk, Kochar; Kochar, SK

doi:10.1080/20477724.2016.1213948

Cited by 7 publications

(6 citation statements)

References 30 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its incidence may represent an actual frequency in vivax malaria in non-immune patients. In the present study, retinal haemorrhage patients did not present any other severe complications, although a correlation between retinal haemorrhage and the severity of vivax malaria has been previously reported [ 44 ].…”

Section: Discussionsupporting

confidence: 41%

Severe Plasmodium vivax infection in Korea

Kwon

Baek

et al. 2017

Malar J

View full text Add to dashboard Cite

BackgroundAlthough severe malaria by Plasmodium vivax has been increasingly reported, there are marked variations in the type and rate of the complications by geographic area. This is possibly because of the presence of concurrent falciparum malaria or bacteraemia, and of differences in underlying immune status among the infected subjects. Furthermore, published studies on P. vivax in temperate regions are limited. The present study investigated severe vivax malaria in Korea, where only vivax malaria occurs. Hence, other compounding factors are rare. Additionally, most of the patients are possibly non-immune to this malarial disease.MethodsAdults with vivax malaria observed in one 860-bed university hospital from January 2006 to December 2012 were retrospectively evaluated. Seventeen patients who had travelled overseas within 6 months before the presentation of malaria were excluded. Severe vivax malaria was diagnosed according to World Health Organization criteria. Other complications were also investigated.ResultsTwo-hundred and ten patients were enrolled, of which 88 (41.9%) were treated as inpatients and the remainder as outpatients. Eleven patients were treated in an intensive care unit; among them, five patients received mechanical ventilation, and one needed extracorporeal membrane oxygenation therapy (ECMO) additionally. Severe vivax malaria was identified in 44 patients (21.0%), and the most common severe complication was pulmonary manifestation (40/188, 21.9%), which was followed by cerebral malaria (5/210, 2.4%), shock (4/210, 1.9%), spontaneous bleeding (3/210, 1.4%), metabolic acidosis (3/210, 3.5%) and acute kidney injury (2/210, 1.0%). Unusual complications, such as splenic infarction (ten patients) and retinal haemorrhage (two patients) were sometimes observed. There were no deaths, but the case involving ECMO was potentially fatal.Conclusions Plasmodium vivax infection can be severe to be fatal and is frequently associated with various complications in non-immune adults. The frequency of each complication seems to differ from other countries. Hence, further investigation is needed to elucidate the causes and mechanisms responsible for these differences.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1684-4) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 41%

Severe Plasmodium vivax infection in Korea

Kwon

Baek

et al. 2017

Malar J

View full text Add to dashboard Cite

show abstract

“…The mortality rates associated with malarial retinopathy has been shown to be higher than those in previous studies. (Kochar A et al, Beare NA et al) [5,6] . The mortality in children with retinal hemorrhages in our study (66.7%) is much higher than previous studies (37.5%) although similar to a study by Singh J et al [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Sample size and absence of a comparator group maybe the possible lacunae of our study. Presence of retinopathy, particularly retinal whitening in non-cerebral forms of severe malaria may prove to be a deterrent in finding a correlation between retinal findings and mortality in cerebral malaria cases in children 6 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and prognostic significance of retinal findings in pediatric cerebral malaria cases at a Tertiary Care Centre in eastern India

Singh¹,

Kumar²,

Sinha³

2019

Int. J. Med. Ophthalmol.

View full text Add to dashboard Cite

To find out the prevalence of retinal findings in pediatric cerebral malaria cases and their correlation, if any, with the final disease outcome. Material and method:The fundi of all pediatric cerebral malaria cases admitted at a tertiary care center in east India over a period of 15 months were examined by direct and indirect ophthalmoscopy for the presence of retinal signs of cerebral malaria, which include retinal hemorrhage, papilledema, vessel discoloration and retinal whitening. The patients were treated for malaria and final disease outcome was documented Result: Almost half of the cases of pediatric cerebral malaria had the presence of retinal signs. These were associated with poorer disease outcome and increased mortality. Among specific signs retinal hemorrhage had maximum association with increased mortality while retinal whitening didn't have any significant association with mortality Conclusion: The presence of retinal signs in cerebral malaria is a significant predictor of prolonged coma and death. Thus the physician can decide which cases demand more aggressive treatment just by looking at their fundus.

show abstract

“…Over 75% of cerebral malaria cases were reported from one of India 53.7% (807/1,502), Colombia 11.9% (178/1,502), or Indonesia 10.2% (153/1,502) ( Fig 2 ). A small number of articles described retinal changes, including hemorrhages, cotton wool spots, and papilledema occurring in complicated vivax malaria [ 46 ], Vivax malaria has also been reported as presenting as a cerebral infarct or cerebral venous sinus thrombosis [ 47 , 48 ].…”

Section: Clinical Features Of Vivax Malariamentioning

confidence: 99%

Clinical impact of vivax malaria: A collection review

et al. 2022

View full text Add to dashboard Cite

Background Plasmodium vivax infects an estimated 7 million people every year. Previously, vivax malaria was perceived as a benign condition, particularly when compared to falciparum malaria. Reports of the severe clinical impacts of vivax malaria have been increasing over the last decade. Methods and findings We describe the main clinical impacts of vivax malaria, incorporating a rapid systematic review of severe disease with meta-analysis of data from studies with clearly defined denominators, stratified by hospitalization status. Severe anemia is a serious consequence of relapsing infections in children in endemic areas, in whom vivax malaria causes increased morbidity and mortality and impaired school performance. P. vivax infection in pregnancy is associated with maternal anemia, prematurity, fetal loss, and low birth weight. More than 11,658 patients with severe vivax malaria have been reported since 1929, with 15,954 manifestations of severe malaria, of which only 7,157 (45%) conformed to the World Health Organization (WHO) diagnostic criteria. Out of 423 articles, 311 (74%) were published since 2010. In a random-effects meta-analysis of 85 studies, 68 of which were in hospitalized patients with vivax malaria, we estimated the proportion of patients with WHO-defined severe disease as 0.7% [95% confidence interval (CI) 0.19% to 2.57%] in all patients with vivax malaria and 7.11% [95% CI 4.30% to 11.55%] in hospitalized patients. We estimated the mortality from vivax malaria as 0.01% [95% CI 0.00% to 0.07%] in all patients and 0.56% [95% CI 0.35% to 0.92%] in hospital settings. WHO-defined cerebral, respiratory, and renal severe complications were generally estimated to occur in fewer than 0.5% patients in all included studies. Limitations of this review include the observational nature and small size of most of the studies of severe vivax malaria, high heterogeneity of included studies which were predominantly in hospitalized patients (who were therefore more likely to be severely unwell), and high risk of bias including small study effects. Conclusions Young children and pregnant women are particularly vulnerable to adverse clinical impacts of vivax malaria, and preventing infections and relapse in this groups is a priority. Substantial evidence of severe presentations of vivax malaria has accrued over the last 10 years, but reporting is inconsistent. There are major knowledge gaps, for example, limited understanding of the underlying pathophysiology and the reason for the heterogenous geographical distribution of reported complications. An adapted case definition of severe vivax malaria would facilitate surveillance and future research to better understand this condition.

show abstract

Retinopathy of vivax malaria in adults and its relation with severity parameters

Cited by 7 publications

References 30 publications

Severe Plasmodium vivax infection in Korea

Severe Plasmodium vivax infection in Korea

Prevalence and prognostic significance of retinal findings in pediatric cerebral malaria cases at a Tertiary Care Centre in eastern India

Clinical impact of vivax malaria: A collection review

Contact Info

Product

Resources

About