scholarly journals Evidence and Implications of Mortality Associated with Acute Plasmodium vivax Malaria

2013 ◽  
Vol 26 (1) ◽  
pp. 36-57 ◽  
Author(s):  
J. Kevin Baird
Keyword(s):  
Vivax Malaria ◽  
Clinical Evidence ◽  
Severe Disease ◽  
Single Species ◽  
Complex Problem ◽  
Low Grade ◽  
Systematic Analysis ◽  
Significant Burden ◽  
Plasmodium Vivax Malaria ◽  
Significant Mortality

SUMMARYVivax malaria threatens patients despite relatively low-grade parasitemias in peripheral blood. The tenet of death as a rare outcome, derived from antiquated and flawed clinical classifications, disregarded key clinical evidence, including (i) high rates of mortality in neurosyphilis patients treated with vivax malaria; (ii) significant mortality from zones of endemicity; and (iii) the physiological threat inherent in repeated, very severe paroxysms in any patient, healthy or otherwise. The very well-documented course of this infection, with the exception of parasitemia, carries all of the attributes of “perniciousness” historically linked to falciparum malaria, including severe disease and fatal outcomes. A systematic analysis of the parasite biomass in severely ill patients that includes blood, marrow, and spleen may ultimately explain this historic misunderstanding. Regardless of how this parasite is pernicious, recent data demonstrate that the infection comes with a significant burden of morbidity and associated mortality. The extraordinary burden of malaria is not heavily weighted upon any single continent by a single species of parasite—it is a complex problem for the entire endemic world, and both species are of fundamental importance. Humanity must rally substantial resources, intellect, and energy to counter this daunting but profound threat.

scholarly journals Hematologic profiles of Plasmodium vivax Malaria patients

2018 ◽  
Vol 2 (2) ◽  
pp. 8-15
Author(s):  
Gita Dwi Prasasty ◽  
Thia Prameswarie ◽  
Muhaimin Ramdja ◽  
Dwi Handayani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Severe Disease ◽  
Host Immune System ◽  
Cross Sectional ◽  
Primary Health ◽  
Plasmodium Vivax Malaria ◽  
Cross Sectional Design

Abstract Background: Malaria infections cause various symptoms ranging from asymptomatic infections to severe disease complications. Plasmodium vivax malaria has been recognized as a disease that attacks blood cells, causing various hematologic changes, especially anemia, leukopenia, leukocytosis, neutropenia, neutrophilia, and thrombocytopenia with different percentages. Plasmodium vivax, formerly known to cause mild malaria, was later proven to cause severe malaria, even cerebral malaria such as Plasmodium falciparum. This study aims to determine the hematologic profile in patients with Plasmodium vivax malaria. Method: This research use descriptive cross sectional design. This research was conducted in Puskesmas (PKM; Primary Health Care) Sukamaju and Puskesmas (PKM; Primary Health Care) Karang City in August until December 2017. Samples were taken by consecutive sampling. A total of 37 samples expressed  positive Plasmodium vivax, examined their hematologic profiles specifically hemoglobin, erythrocytes, leucocytes, platelets, lymphocytes, neutrophils, monocytes and hematocrit using automatic hematology cell counter. Results: Based on the results of this study, 56.76% of patients had anemia, 45.90% of patients had  leukopenia, 89.20% thrombocytopenia, 2.70% neutrophilia, 10.80% neutropenia, 2.70% lymphocytosis, 35.10% lymphopenia, and 13.50% pancytopenia. Conclusion: In patients with Plasmodium vivax malaria infection there may be a change in hematologic profiles, this change may be affected by the acute phase of infection and host immune system.   Keywords: Plasmodium vivax malaria, hematologic profiles

scholarly journals Nitric Oxide–Dependent Endothelial Dysfunction and Reduced Arginine Bioavailability in Plasmodium vivax Malaria but No Greater Increase in Intravascular Hemolysis in Severe Disease

2016 ◽  
Vol 214 (10) ◽  
pp. 1557-1564 ◽  
Author(s):  
Bridget E. Barber ◽  
Timothy William ◽  
Matthew J. Grigg ◽  
Kim A. Piera ◽  
Youwei Chen ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Severe Disease ◽  
Healthy Controls ◽  
Intravascular Hemolysis ◽  
Plasmodium Vivax Malaria ◽  
Arginine Level

Background Pathogenesis of severe Plasmodium vivax malaria is poorly understood. Endothelial dysfunction and reduced nitric oxide (NO) bioavailability characterize severe falciparum malaria, but have not been assessed in severe vivax malaria. Methods In patients with severe vivax malaria (n = 9), patients with nonsevere vivax malaria (n = 58), and healthy controls (n = 79), we measured NO-dependent endothelial function by using reactive hyperemia–peripheral arterial tonometry (RH-PAT) and assessed associations with arginine, asymmetric dimethylarginine (ADMA), and hemolysis. Results The L-arginine level and the L-arginine to ADMA ratio (a measure of L-arginine bioavailability) were reduced in patients with severe vivax malaria and those with nonsevere vivax malaria, compared with healthy controls (median L-arginine level, 65, 66, and 98 µmol/mL, respectively [P = .0001]; median L-arginine to ADMA ratio, 115, 125, and 187, respectively [P = .0001]). Endothelial function was impaired in proportion to disease severity (median RH-PAT index, 1.49, 1.73, and 1.97 in patients with severe vivax malaria, those with nonsevere vivax malaria, and healthy controls, respectively; P = .018) and was associated with the L-arginine to ADMA ratio. While the posttreatment fall in hemoglobin level was greater in severe vivax malaria as compared to nonsevere vivax malaria (2.5 vs 1 g/dL; P = .0001), markers of intravascular hemolysis were not higher in severe disease. Conclusions Endothelial function is impaired in nonsevere and severe vivax malaria, is associated with reduced L-arginine bioavailability, and may contribute to microvascular pathogenesis. Severe disease appears to be more associated with extravascular hemolysis than with intravascular hemolysis.

scholarly journals Platelet disturbances correlate with endothelial cell activation in uncomplicated Plasmodium vivax malaria

2020 ◽  
Vol 14 (7) ◽  
pp. e0007656
Author(s):  
João Conrado Khouri Dos-Santos ◽  
João Luiz Silva-Filho ◽  
Carla C. Judice ◽  
Ana Carolina Andrade Vitor Kayano ◽  
Júlio Aliberti ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Cell Activation ◽  
Endothelial Cell Activation ◽  
Plasmodium Vivax Malaria

scholarly journals Cancer Related Anemia: An Integrated Multitarget Approach and Lifestyle Interventions

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 482
Author(s):  
Valentina Natalucci ◽  
Edy Virgili ◽  
Federica Calcagnoli ◽  
Giacomo Valli ◽  
Deborah Agostini ◽  
...  
Keyword(s):  
Iron Homeostasis ◽  
Iron Concentration ◽  
Transferrin Saturation ◽  
Intravenous Iron ◽  
Complex Problem ◽  
Low Grade ◽  
Inflammatory Status ◽  
Line Of Therapy ◽  
Cancer Related Anemia ◽  
Low Grade Inflammation

Cancer is often accompanied by worsening of the patient’s iron profile, and the resulting anemia could be a factor that negatively impacts antineoplastic treatment efficacy and patient survival. The first line of therapy is usually based on oral or intravenous iron supplementation; however, many patients remain anemic and do not respond. The key might lie in the pathogenesis of the anemia itself. Cancer-related anemia (CRA) is characterized by a decreased circulating serum iron concentration and transferrin saturation despite ample iron stores, pointing to a more complex problem related to iron homeostatic regulation and additional factors such as chronic inflammatory status. This review explores our current understanding of iron homeostasis in cancer, shedding light on the modulatory role of hepcidin in intestinal iron absorption, iron recycling, mobilization from liver deposits, and inducible regulators by infections and inflammation. The underlying relationship between CRA and systemic low-grade inflammation will be discussed, and an integrated multitarget approach based on nutrition and exercise to improve iron utilization by reducing low-grade inflammation, modulating the immune response, and supporting antioxidant mechanisms will also be proposed. Indeed, a Mediterranean-based diet, nutritional supplements and exercise are suggested as potential individualized strategies and as a complementary approach to conventional CRA therapy.

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