Are respiratory complications of Plasmodium vivax malaria an underestimated problem?

• Published in: Malaria Journal
• Main Authors: Fernando Val, Sara Avalos, André Alexandre Gomes, José Evelio Albornoz Zerpa, Gustavo Fontecha, André Machado Siqueira, Quique Bassat, Maria Graças Costa Alecrim, Wuelton Marcelo Monteiro, Marcus Vinícius Guimarães Lacerda
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2017
• Subjects: Plasmodium vivax; Severe malaria; Respiratory distress; Lung; Case fatality; Prevalence; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-017-2143-y; https://doaj.org/article/23b3c740b044435b944c2988d2f4d306

Abstract Background Respiratory complications are uncommon, but often life-threatening features of Plasmodium vivax malaria. This study aimed to estimate the prevalence and lethality associated with such complications among P. vivax malaria patients in a tertiary hospital in the Western Brazilian Amazon, and to identify variables associated with severe respiratory complications, intensive care need and death. Medical records from 2009 to 2016 were reviewed aiming to identify all patients diagnosed with P. vivax malaria and respiratory complications. Prevalence, lethality and risk factors associated with WHO defined respiratory complications, intensive care need and death were assessed. Results A total of 587 vivax malaria patients were hospitalized during the study period. Thirty (5.1%) developed respiratory complications. Thirteen (43.3%) developed severe respiratory complications, intensive care was required for 12 (40%) patients and 5 (16.6%) died. On admission, anaemia and thrombocytopaenia were common findings, whereas fever was unusual. Patients presented different classes of parasitaemia and six were aparasitaemic on admission. Time to respiratory complications occurred after anti-malarials administration in 18 (60%) patients and progressed very rapidly. Seventeen patients (56.7%) had comorbidities and/or concomitant conditions, which were significantly associated to higher odds of developing severe respiratory complications, need for intensive care and death (p < 0.05). Conclusion Respiratory complications were shown to be associated with significant mortality in this population. Patients with comorbidities and/or concomitant conditions require special attention to avoid this potential life-threatening complication.