scholarly journals Multiplicity of Infection and Disease Severity in Plasmodium vivax

2016 ◽  
Vol 10 (1) ◽  
pp. e0004355 ◽  
Author(s):  
M. Andreína Pacheco ◽  
Mary Lopez-Perez ◽  
Andrés F. Vallejo ◽  
Sócrates Herrera ◽  
Myriam Arévalo-Herrera ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Disease Severity ◽  
Multiplicity Of Infection

scholarly journals Platelet count and Superoxide Dismutase as a marker for severity of Plasmodium infection.

2017 ◽  
Vol 5 (11) ◽  
pp. 4864
Author(s):  
Archana Shetty ◽  
Teerthanath Srinivas ◽  
Hariprasad Srinivas
Keyword(s):  
Public Health ◽  
Superoxide Dismutase ◽  
Platelet Count ◽  
Plasmodium Vivax ◽  
Disease Severity ◽  
Mixed Infection ◽  
Severe Infection ◽  
Care Hospital ◽  
Peripheral Smear ◽  
The Mean

Background: Malaria continues to be an important public health problem in developing and underdeveloped countries with high morbidity and mortality. It continues to be one of the major public health problems in India. Plasmodium vivax is the major parasite type causing malaria and Plasmodium falciparum is the major cause of serious and complicated disease. Haematological abnormality which is most commonly seen in malaria is thrombocytopenia followed by anaemia. Identification of predictors of disease severity is critical to improve patient care. This study was undertaken to evaluate the severity of thrombocytopenia and erythrocyte SOD level in infections by plasmodium vivax, falciparum and mixed infection.Methods: A hospital based cross sectional study done on confirmed cases of malaria in a tertiary care hospital in costal Karnataka. All patients tested positive for malaria (either by rapid diagnostic test or peripheral smear) were included and patients presenting with fever who were but treated empirically for malaria were excluded in the study. The type of malarial infection was diagnosed with QBC and thin peripheral smear method; platelet count was done by automated cell counter and estimation of superoxide dismutase (SOD) by nitro blue tetrazolium chloride reduction method.Results: A total of forty infected malaria patients were evaluated. The age range of the infective patients were between 15 to 70 years. Males were more commonly affected than females in the ratio of 5.6:1. The most common type of malaria infection was from P. vivax and mixed infection (40% each) followed by P. falciparum (20%). Majority (50%) of the patient had severe infection followed by mild infection (35%) and moderate infection. The mean platelet count was 1,14,250/cu mm in P.falciparum, 85,000/cu mm in P.vivax infection and 60,625/cu mm in mixed infection. The mean platelet count was least (56,181/cu mm) in severe infective patients than in moderate (91,666/cu mm) and mild (1,21,500/cu mm) infections. The SOD levels was reduced more in P. vivax (26.43U/mg Hb) and mixed infection (20.96U/mg Hb) than P.falciparum (32.74U/mg Hb). SOD levels were proportionally low in severe infection (14.94U/mg Hb), when compared to moderate (20.35 U/mg Hb) and mild infection (32.19 U/mg Hb).Conclusions: Anaemia and thrombocytopenia are the most frequent haematological complications associated malaria. Thrombocytopenia is associated with increase in parasite density and severity of the infection, its more common in P.vivax and mixed infection than P.falciparum infection. The SOD level substantially reduces depending on the severity of malaria. Thrombocytopenia and reduced SOD level is a powerful predictor of disease severity. These parameters could be useful in the clinical approach of patients with malaria for prompt timely initiation of anti-malarial therapy and reduce the mortality.

scholarly journals Efficacy of Primaquine in Preventing Short- and Long-Latency Plasmodium vivax Relapses in Nepal

2019 ◽  
Vol 220 (3) ◽  
pp. 448-456 ◽  
Author(s):  
Komal Raj Rijal ◽  
Bipin Adhikari ◽  
Prakash Ghimire ◽  
Megha Raj Banjara ◽  
Garib Das Thakur ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Standard Dose ◽  
Radical Cure ◽  
Multiplicity Of Infection ◽  
Microsatellite Genotyping ◽  
Long Latency ◽  
To Receive ◽  
Relapse Patterns

Abstract Background Plasmodium vivax is the main cause of malaria in Nepal. Relapse patterns have not been characterized previously. Methods Patients with P. vivax malaria were randomized to receive chloroquine (CQ; 25 mg base/kg given over 3 days) alone or together with primaquine (PQ; 0.25 mg base/kg/day for 14 days) and followed intensively for 1 month, then at 1- to 2-month intervals for 1 year. Parasite isolates were genotyped. Results One hundred and one (49%) patients received CQ and 105 (51%) received CQ + PQ. In the CQ + PQ arm, there were 3 (4.1%) recurrences in the 73 patients who completed 1 year of follow-up compared with 22 of 78 (28.2%) in the CQ-only arm (risk ratio, 0.146 [95% confidence interval, .046–.467]; P < .0001). Microsatellite genotyping showed relatively high P. vivax genetic diversity (mean heterozygosity, 0.843 [range 0.570–0.989] with low multiplicity of infection (mean, 1.05) reflecting a low transmission preelimination setting. Of the 12 genetically homologous relapses, 5 (42%) occurred in a cluster after 9 months, indicating long latency. Conclusions Although there may be emerging CQ resistance, the combination of CQ and the standard-dose 14-day PQ regimen is highly efficacious in providing radical cure of short- and long-latency P. vivax malaria in Nepal.

scholarly journals Dissecting Disease Tolerance in Plasmodium vivax Malaria Using the Systemic Degree of Inflammatory Perturbation

2021 ◽  
Author(s):  
Caian L. Vinhaes ◽  
Thomas A. Carmo ◽  
Artur T. L. Queiroz ◽  
Kiyoshi F. Fukutani ◽  
María B Arriaga ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Disease Severity ◽  
Systemic Inflammation ◽  
Immune Activation ◽  
Vivax Malaria ◽  
Asymptomatic Malaria ◽  
Plasma Samples ◽  
Disease Tolerance ◽  
Disease Outcomes ◽  
Epidemiologic Characteristics

AbstractHomeostatic perturbation caused by infection fosters two major defense stratagems, resistance and tolerance, which promote the host’s survival. Resistance relates to the ability of the host to restrict the pathogen load. Tolerance minimizes collateral tissue damage without directly affecting pathogen fitness. These concepts have been explored mechanistically in murine models of malaria but only superficially in human disease. Indeed, individuals infected with Plasmodium vivax may present with asymptomatic malaria, only mild symptoms, or be severely ill. We and others have reported a diverse repertoire of immunopathological events that potentially underly susceptibility to disease severity in vivax malaria. Nevertheless, the combined epidemiologic, clinical, parasitological, and immunologic features associated with defining the disease outcomes are still not fully understood. In the present study, we perform an extensive outlining of cytokines and inflammatory proteins in plasma samples from a cohort of individuals from the Brazilian Amazon infected with P. vivax and presenting with asymptomatic (n=108) or symptomatic (n=134) disease (106 with mild presentation and 28 with severe malaria), as well as from uninfected endemic controls (n=128) to elucidate these gaps further. We employ highly multidimensional Systems Immunology analyses using the molecular degree of perturbation to reveal nuances of a unique profile of systemic inflammation and imbalanced immune activation directly linked to disease severity as well as with other clinical and epidemiologic characteristics. The findings mapped the relationships between the systemic degree of inflammatory perturbation and parasitemia values to define the disease tolerance in vivax malaria.Author SummaryPlasmodium vivax infection can result in a broad spectrum of disease manifestations, ranging from asymptomatic malaria to severe life-threatening disease. Despite significant advances in the current understanding of the critical factors associated with the disease outcomes in vivax malaria, the immunopathological events responsible for the diversity of severe manifestations in the disease remain deeply unknown. Here, a large panel of cytokines/chemokines were assessed in plasma samples from a Brazilian cohort of P. vivax patients presenting with asymptomatic infection or symptomatic malaria at the time of diagnosis, as well as from uninfected endemic controls, to define the relationships between systemic inflammation, disease presentation, parasitemia, and epidemiologic characteristics. In-depth analyses using the molecular degree of perturbation were employed to reveal nuances of a unique profile of systemic inflammation and imbalanced immune activation directly linked to disease severity. Moreover, the discoveries diagrammed the occurrence of disease tolerance by narrowing down the interactions between the systemic degree of inflammatory perturbation and parasitemia values in vivax malaria patients.

scholarly journals Dissecting disease tolerance in Plasmodium vivax malaria using the systemic degree of inflammatory perturbation

2021 ◽  
Vol 15 (11) ◽  
pp. e0009886
Author(s):  
Caian L. Vinhaes ◽  
Thomas A. Carmo ◽  
Artur T. L. Queiroz ◽  
Kiyoshi F. Fukutani ◽  
Mariana Araújo-Pereira ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Disease Severity ◽  
Tissue Damage ◽  
Vivax Malaria ◽  
Asymptomatic Malaria ◽  
Disease Tolerance ◽  
Markers Of Inflammation ◽  
Systems Immunology ◽  
Main Factor

Homeostatic perturbation caused by infection fosters two major defense strategies, resistance and tolerance, which promote the host’s survival. Resistance relates to the ability of the host to restrict the pathogen load. Tolerance minimizes collateral tissue damage without directly affecting pathogen fitness. These concepts have been explored mechanistically in murine models of malaria but only superficially in human disease. Indeed, individuals infected with Plasmodium vivax may present with asymptomatic malaria, only mild symptoms, or be severely ill. We and others have reported a diverse repertoire of immunopathological events that potentially underly susceptibility to disease severity in vivax malaria. Nevertheless, the combined epidemiologic, clinical, parasitological, and immunologic features associated with defining the disease outcomes are still not fully understood. In the present study, we perform an extensive outlining of cytokines and inflammatory proteins in plasma samples from a cohort of individuals from the Brazilian Amazon infected with P. vivax and presenting with asymptomatic (n = 108) or symptomatic (n = 134) disease (106 with mild presentation and 28 with severe malaria), as well as from uninfected endemic controls (n = 128) to elucidate these gaps further. We employ highly multidimensional Systems Immunology analyses using the molecular degree of perturbation to reveal nuances of a unique profile of systemic inflammation and imbalanced immune activation directly linked to disease severity as well as with other clinical and epidemiologic characteristics. Additionally, our findings reveal that the main factor associated with severe cases of P. vivax infection was the number of symptoms, despite of a lower global inflammatory perturbation and parasitemia. In these participants, the number of symptoms directly correlated with perturbation of markers of inflammation and tissue damage. On the other hand, the main factor associated with non-severe infections was the parasitemia values, that correlated only with perturbation of inflammatory markers, such as IL-4 and IL-1β, with a relatively lower number of symptoms. These observations suggest that some persons present severe vivax regardless of pathogen burden and global inflammatory perturbation. Such patients are thus little tolerant to P. vivax infection and show higher susceptibility to disrupt homeostasis and consequently exhibit more clinical manifestations. Other persons are capable to tolerate higher parasitemia with lower inflammatory perturbation and fewer symptoms, developing non-severe malaria. The analytical approach presented here has capability to define in more details the determinants of disease tolerance in vivax malaria.

Vitamin D levels are not associated with non-alcoholic fatty liver disease severity in a Brazilian population

2020 ◽  
pp. 1-8
Author(s):  
Jeniffer Danielle M. Dutra ◽  
Quelson Coelho Lisboa ◽  
Silvia Marinho Ferolla ◽  
Carolina Martinelli M. L. Carvalho ◽  
Camila Costa M. Mendes ◽  
...  
Keyword(s):  
Vitamin D ◽  
Liver Disease ◽  
Fatty Liver ◽  
Disease Severity ◽  
Fatty Liver Disease ◽  
Hypovitaminosis D ◽  
Alcoholic Fatty Liver ◽  
Vitamin D Levels ◽  
The Mean ◽  
Alcoholic Fatty Liver Disease

Abstract. Some epidemiological evidence suggests an inverse correlation between non-alcoholic fatty liver disease (NAFLD) frequency and vitamin D levels. Likewise, a beneficial effect of vitamin D on diabetes mellitus (DM) and insulin resistance has been observed, but this is an unsolved issue. Thus, we aimed to investigate the prevalence of hypovitaminosis D in a NAFLD Brazilian population and its association with disease severity and presence of comorbidities. In a cross-sectional study, the clinical, biochemical and histological parameters of 139 NAFLD patients were evaluated according to two different cut-off points of serum 25-hydroxyvitamin D levels (20 ng/mL and 30 ng/mL). The mean age of the population was 56 ± 16 years, most patients were female (83%), 72% had hypertension, 88% dyslipidemia, 46% DM, 98% central obesity, and 82% metabolic syndrome. Serum vitamin D levels were < 30 ng/mL in 78% of the patients, and < 20 ng/mL in 35%. The mean vitamin D level was 24.3 ± 6.8 ng/mL. The comparison between the clinical, biochemical and histological characteristics of the patients according to the levels of vitamin D showed no significant difference. Most patients with NAFLD had hypovitaminosis D, but low vitamin D levels were not related to disease severity and the presence of comorbidities.

Sign in / Sign up

Export Citation Format

Share Document