Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast
Background Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malar...
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Published in | Malaria journal Vol. 13; no. 1; p. 280 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
BioMed Central
22.07.2014
BioMed Central Ltd |
Subjects | |
Online Access | Get full text |
ISSN | 1475-2875 1475-2875 |
DOI | 10.1186/1475-2875-13-280 |
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Abstract | Background
Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject.
Methods
A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011.
Results
Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria.
Plasmodium vivax
and
Plasmodium falciparum
were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between
P. vivax
(14 cases, 9%) and
P. falciparum
(7 cases, 10%) infections.
Conclusions
Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that
P. vivax
infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. |
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AbstractList | Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. Background Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. Methods A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Results Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Conclusions Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject.BACKGROUNDAlthough malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject.A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011.METHODSA retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011.Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections.RESULTSAmongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections.Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment.CONCLUSIONSSevere malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. Background: Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. Methods: A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Results: Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Conclusions: Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. Background Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. Methods A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Results Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Conclusions Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. Keywords: Malaria, Non-endemic area, Brazil, Plasmodium vivax, Plasmodium falciparum, Severity, Epidemiology Doc number: 280 Abstract Background: Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. Methods: A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Results: Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Conclusions: Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment. |
ArticleNumber | 280 |
Audience | Academic |
Author | Garcia, Márcia T Castiñeiras, Catarina M S Moretti, Maria L Costa, Fabio T M Lacerda, Marcus V G Albrecht, Letusa Levy, Carlos E Lopes, Stefanie C P Angerami, Rodrigo N Dos-Santos, João C K |
AuthorAffiliation | 7 Universidade do Estado do Amazonas, Manaus, AM, Brazil 1 Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil 3 Seção de Epidemiologia Hospitalar, Hospital das Clínicas, UNICAMP, Campinas, SP, Brazil 4 Departamento de Clínica Médica, Faculdade de Ciências Médicas, UNICAMP, Campinas, SP, Brazil 2 Faculdade de Ciências Médicas, UNICAMP, Campinas, SP, Brazil 5 Departamento de Patologia Clínica, UNICAMP, Campinas, SP, Brazil 6 Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil |
AuthorAffiliation_xml | – name: 2 Faculdade de Ciências Médicas, UNICAMP, Campinas, SP, Brazil – name: 7 Universidade do Estado do Amazonas, Manaus, AM, Brazil – name: 1 Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil – name: 4 Departamento de Clínica Médica, Faculdade de Ciências Médicas, UNICAMP, Campinas, SP, Brazil – name: 5 Departamento de Patologia Clínica, UNICAMP, Campinas, SP, Brazil – name: 6 Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil – name: 3 Seção de Epidemiologia Hospitalar, Hospital das Clínicas, UNICAMP, Campinas, SP, Brazil |
Author_xml | – sequence: 1 givenname: João C K surname: Dos-Santos fullname: Dos-Santos, João C K organization: Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, UNICAMP – sequence: 2 givenname: Rodrigo N surname: Angerami fullname: Angerami, Rodrigo N organization: Seção de Epidemiologia Hospitalar, Hospital das Clínicas, UNICAMP – sequence: 3 givenname: Catarina M S surname: Castiñeiras fullname: Castiñeiras, Catarina M S organization: Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP) – sequence: 4 givenname: Stefanie C P surname: Lopes fullname: Lopes, Stefanie C P organization: Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP) – sequence: 5 givenname: Letusa surname: Albrecht fullname: Albrecht, Letusa organization: Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP) – sequence: 6 givenname: Márcia T surname: Garcia fullname: Garcia, Márcia T organization: Seção de Epidemiologia Hospitalar, Hospital das Clínicas, UNICAMP – sequence: 7 givenname: Carlos E surname: Levy fullname: Levy, Carlos E organization: Departamento de Patologia Clínica, UNICAMP – sequence: 8 givenname: Maria L surname: Moretti fullname: Moretti, Maria L organization: Seção de Epidemiologia Hospitalar, Hospital das Clínicas, UNICAMP, Departamento de Clínica Médica, Faculdade de Ciências Médicas, UNICAMP – sequence: 9 givenname: Marcus V G surname: Lacerda fullname: Lacerda, Marcus V G organization: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Universidade do Estado do Amazonas – sequence: 10 givenname: Fabio T M surname: Costa fullname: Costa, Fabio T M email: fabiotmc72@gmail.com organization: Departamento de Genética, Evolução e Bioagentes, Instituo de Biologia, Universidade Estadual de Campinas (UNICAMP) |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25047177$$D View this record in MEDLINE/PubMed |
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Copyright | Dos-Santos et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. COPYRIGHT 2014 BioMed Central Ltd. 2014 Dos-Santos et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Copyright © 2014 Dos-Santos et al.; licensee BioMed Central Ltd. 2014 Dos-Santos et al.; licensee BioMed Central Ltd. |
Copyright_xml | – notice: Dos-Santos et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. – notice: COPYRIGHT 2014 BioMed Central Ltd. – notice: 2014 Dos-Santos et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. – notice: Copyright © 2014 Dos-Santos et al.; licensee BioMed Central Ltd. 2014 Dos-Santos et al.; licensee BioMed Central Ltd. |
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Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria... Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to... Background Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria... Doc number: 280 Abstract Background: Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised... Background: Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported... |
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SubjectTerms | Acquired Immunodeficiency Syndrome - epidemiology Adolescent Adult Anemia - etiology Antimalarials - therapeutic use Artemisinins - therapeutic use Biomedical and Life Sciences Biomedicine Brazil - epidemiology Care and treatment Chloroquine - therapeutic use Comorbidity Data analysis Development and progression Drug dosages Entomology Epidemiology Female Follow-Up Studies Health aspects Hospitals Humans Infections Infectious Diseases Malaria Malaria, Falciparum - blood Malaria, Falciparum - complications Malaria, Falciparum - drug therapy Malaria, Falciparum - epidemiology Malaria, Vivax - blood Malaria, Vivax - complications Malaria, Vivax - drug therapy Malaria, Vivax - epidemiology Male Mefloquine - therapeutic use Microbiology Middle Aged Parasitemia - epidemiology Parasitemia - parasitology Parasitology Patient outcomes Plasmodium falciparum Plasmodium vivax Primaquine - therapeutic use Public Health Recurrence Retrospective Studies Studies Tertiary Care Centers - statistics & numerical data Thrombocytopenia - etiology Travel Tropical diseases Tropical Medicine Young Adult |
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Title | Imported malaria in a non-endemic area: the experience of the university of Campinas hospital in the Brazilian Southeast |
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