Severe and Complicated Falciparum Malaria in Melanesian Adults in Papua New Guinea *

Lalloo, David G.; Trevett, A.J.; Paul, Mark; Korinhona, Andrew; Laurenson, Ian F.; Mapao, J.; Nwokolo, Nneka; Danga-Christian, Brunie; Black, Julie; Saweri, Adolf; Naraqi, S; Warrell, David A.

doi:10.4269/ajtmh.1996.55.119

Cited by 54 publications

(32 citation statements)

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“…48 Signs that are rare in childhood malaria-eg, acute renal failure, pulmonary oedema, and severe jaundice-are common manifestations of severe malaria in adults. 55,78 Death during pregnancy or just after delivery occurs because of cerebral malaria, renal failure, hepatic impairment, severe anaemia, hypoglycaemia (worse with quinine treatment), uncontrollable post-partum haemorrhage, or acute respiratory distress syndrome. 30,48,70,[78][79][80] Pregnant women have a three-times higher risk of severe malaria than do non-pregnant women.…”

Section: P Vivaxmentioning

confidence: 99%

“…55,78 Death during pregnancy or just after delivery occurs because of cerebral malaria, renal failure, hepatic impairment, severe anaemia, hypoglycaemia (worse with quinine treatment), uncontrollable post-partum haemorrhage, or acute respiratory distress syndrome. 30,48,70,[78][79][80] Pregnant women have a three-times higher risk of severe malaria than do non-pregnant women. 53,55 In eight studies of severe malaria in pregnancy (n=227), 52,78-84 the median maternal mortality was 39% (range .…”

Section: P Vivaxmentioning

confidence: 99%

“…79 By contrast, all women with renal failure died. 78 In an autopsy study of 277 women in India, 85 10% of maternal mortality was attributable to infectious diseases, of which tuberculosis, malaria, and leptospirosis were most common. In reports from India, 35,60,86 women with severe vivax malaria had very poor pregnancy outcomes and maternal mortality was reported.…”

Section: P Vivaxmentioning

confidence: 99%

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Malaria in pregnancy in the Asia-Pacific region

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McGready

Boel

et al. 2012

The Lancet Infectious Diseases

163

154

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Section: P Vivaxmentioning

confidence: 99%

Section: P Vivaxmentioning

confidence: 99%

Section: P Vivaxmentioning

confidence: 99%

See 1 more Smart Citation

Malaria in pregnancy in the Asia-Pacific region

Rijken

McGready

Boel

et al. 2012

The Lancet Infectious Diseases

163

154

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“…8 Incidence of cerebral malaria in a study conducted by VB Singh et al was 9.57%, study from New Guinea had 17% presented with cerebral malaria. 11,14 This difference may be attributed to selection of cases. Our study consists of confirmed falciparum malaria cases only, whereas VB singh et al study consists of falciparum, vivax and mixed falciparum and vivax malaria cases.…”

Section: Discussionmentioning

confidence: 99%

Study of neurological manifestations in patients of falciparum malaria

et al. 2018

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Background: Several types of neurological manifestations are associated with falciparum malaria. Cerebral malaria is one of the most dreaded complications. A significant number of survivors are left with disabling neurological sequelae, most of which are self-limiting. Neurological involvement is more frequent with falciparum malaria because of its unique characteristics leading to micro-vascular involvement.Methods: Present study was conducted at department of General Medicine, VIMSAR, Burla (Odisha). This observational study included in total 110 patients, who were confirmed cases of falciparum malaria. Clinical profile including detailed neurological examination with relevant investigations was done. Spectrum of neuropsychiatric manifestations were observed.Results: Out of 110 patients male and female ratio was 1:1 (M 55 and F 55). The mean age of presentation in male was 36.09 + 14.85 yrs. and in female was 31.85 + 14.00 yrs. The major presenting symptoms were fever, headache, vomiting, altered sensorium, altered behaviour and convulsions in their decreasing order of frequency. On neurological evaluation, diminished level of consciousness was found in 56.4% cases. 14% cases had GCS score ≤ 7 and 63% had GCS score ≥ 11. Convulsion was found in 31% cases, cranial neuropathy in 10.9%, cerebellar dysfunction in 12.7%, neck rigidity in 22.7%, speech abnormality in 3.6%, peripheral neuropathy in 8.2%, fundoscopic changes suggestive of retinal involvement in 44.5% cases. Atypical manifestation like; Intracerebral haemorrhage, subarachnoid haemorrhage, cortical venous sinus thrombosis were also found in few cases. 32.72% patients had Neuropsychiatric manifestations at discharge in the form of focal neurological deficits, psychosis, depression, speech disorder, memory loss, cerebellar abnormality & peripheral neuropathy.Conclusions: Neurological manifestations in falciparum malaria patients are common and encompass a wide spectrum of clinical presentation. In an endemic area, falciparum malaria should be kept as a differential diagnosis in patients presenting with atypical neurological manifestations.

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“…Cerebral malaria is the main clinical manifestation of severe P. falciparum infection and seems to be responsible for most deaths. It is characterized by coma, often with convulsions (Lalloo et al, 1996). Severe anaemia is probably the second most common presentation of severe P. falciparum infection and probably results from RBCs destruction, indirect destruction of parasitized erythrocytes by immune mechanisms and reduced erythropoiesis associated with imbalances in cytokine concentrations (Menendez et al, 2000;Ekvall 2003).…”

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confidence: 99%