Teška importovana malarija u tercijarnoj zravstvenoj ustanovi u Srbiji

  • Jasmina Poluga Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia
  • Uroš Karić Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia
  • Zorica Dakić Clinical Centre of Serbia, Parasitological Laboratory, Belgrade, Serbia
  • Nataša Katanić Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia; University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Lidija Lavadinović Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia
  • Branko Milošević Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia
  • Nataša Nikolić Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia
  • Aleksandar Urošević Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia
  • Boris Jegorović Clinical Centre of Serbia, Infectious and Tropical Diseases University Hospital, Department of Microbiology, Belgrade, Serbia
  • Milorad Pavlović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP170509124P
Ključne reči: malarija;, faktor nekroze tumora-alfa;, trombocitopenija;, bolesti, indeks težine;, srbija.

Sažetak


Uvod/Cilj. Svetska zdravstvena organizacija procenjuje da je oko 3,2 milijarde ljudi u riziku od inficiranja malarijom. Dakle, adekvatni dijagnostički protokoli za ovu bolest, naro­čito oni koji su namenjeni za utvrđivanje težine bolesti, od presudnog su značaja u enedemskim i neendemskim regijama. Cilj rada bio je identifikacija demografskih, parazi­toloških kliničkih i laboratorijskih obeležja udruženih sa teškim oblikom malarije u neendemskim regijama. Metode. Analizirali smo 22 bolesnika sa teškom malarijom i uporedili njihove kliničke slike i laboratorijske analize sa nalazima kod bolesnika koji su imali manje teške forme malarije, a sve u cilju identifikovanja prediktora težine bolesti. Svi bolesnici bili su lečeni u Klinici za infektivne i tropske bolesti Kli­nič­kog centra Srbije u Beogradu u periodu od 2000. do 2010. godine. Rezultati. Oboleli od teške malarije su bili prosečne starosti od 44,86 ± 12,33 godina i to pretežno muškarci (95,45%). Plasmodium falciparum (P. falciparum) je bio značajno češći izolat kod bolesnika sa teškom malarijom u odnosu na bolesnike sa lakšim formama malarije (p = 0,047). Oboleli sa teškom formom malarije najčešće su imali žuticu, a zatim anemiju i akutnu bubrežnu slabost. Multifaktorska analiza varijanse pokazala je da su trombocitopenija (p = 0,05) i visoke koncentracije faktora alfa nekroze tumora (p = 0,02) bile značajno povezane sa teškom malarijom. Zaključak. Pri evaluaciji febrilnih bolesnika koji se vraćaju iz područja koja su endemska za malariju potrebno je posumnjati na ovu bolest. Visoke koncentracije faktora nekroze tumora-alfa i trombocitopenija povezane su sa teškom malarijom u neendemskim područjima.

Reference

World Health Organization. Malaria. 2015. [cited 2015 Dec 16]. Available from:

http://www.who.int/mediacentre/factsheets/fs094/en/

World Health Organization. World Malaria Report. Geneva: WHO Document Production Services; 2015.

World Health Organization. Management of severe malaria: A practical handbook. 3rd ed. Geneva: WHO Press; 2012.

World Health Organization. Division of Control of Tropical Dis-eases. Severe and complicated malaria. Trans R Soc Trop Med Hyg 1990; 84(Suppl 2): 1–65.

World Health Organization. Communicable Diseases Cluster. Severe falciparum malaria. Trans R Soc Trop Med Hyg 2000;94(Suppl 1): S1-90.

World Health Organization. Guidelines for the treatment of ma-laria, third ed. Geneva: WHO Press; 2015.

Strydom KA, Ismail F, Frean J. Plasmodium ovale: a case of not-so-benign tertian malaria. Malar J 2014; 13: 85.

Kern P, Hemmer CJ, van Damme J, Gruss HJ, Dietrich M. Ele-vated tumor necrosis factor alpha and interleukin-6 serum levels as markers for complicated Plasmodium falciparum ma-laria. Am J Med 1989; 87(2): 139–43.

Scuderi P, Sterling KE, Lam KS, Finley PR, Ryan KJ, Ray CG, et al. Raised serum levels of tumour necrosis factor in parasitic in¬fections. Lancet 1986; 2(8520): 1364–5.

Day NP, Hien TT, Schollaardt T, Loc PP, Chuong LV, Chau TT, et al. The prognostic and pathophysiologic role of pro- and anti¬inflammatory cytokines in severe malaria. J Infect Dis 1999; 180(4): 1288–97.

Hanson J, Phu NH, Hasan MU, Charunwatthana P, Plewes K, Maude RJ, et al. The clinical implications of thrombocytopenia in adults with severe falciparum malaria: a retrospective analy-sis. BMC Med 2015; 13: 97.

Leowattana W, Tangpukdee N, Thar SK, Nakasiri S, Srivilairit S, Kano S, et al. Changes in platelet count in uncomplicated and severe falciparum malaria. Southeast Asian J Trop Med Public Health 2010; 41(5): 1035–41.

Saravu K, Docherla M, Vasudev A, Shastry BA. Thrombocyto-penia in vivax and falciparum malaria: an observational study of 131 patients in Karnataka, India. Ann Trop Med Parasitol 2011; 105(8): 593–8.

Popovic B, Mikic D, Zeljkovic J, Čekanac R, Vidanović M. Malarija u srpskoj vojsci na Solunskom frontu sa posebnim osvrtom na pocetak epidemije polovinom 1916. godine. Opšta medicina 2008; 14(1–2): 37–44. (Serbian)

Dakić Z, Pelemiš M, Djurković-Djaković O, Lavadinović L, Nikolić A, Stevanović G, et al. Imported malaria in Belgrade, Serbia, be-tween 2001 and 2009. Wien Klin Wochenschr 2011; 123 Suppl 1: 15–9

Institute of Public Health of Serbia “Dr Milan Jovanović Ba-tut”. Godišnji Izveštaji O Zaraznim Bolestima Na Teritoriji Republike Srbije. 2011. Sept. 2011. Web.. [cited 2017 Jul 15]. Available from: http://www.batut.org.rs/index.php?content

Mikic D, Djokic M, Bojic I, Pavlovic M, Balint B, Vucinic Z, et al. A severe form of falciparum malaria associated with staphylo-coccal endocarditis. Vojnosanit Pregl 2001; 58(6): 689–94. (Serbian)

Seringe E, Thellier M, Fontanet A, Legros F, Bouchaud O, Ancelle T, et al. French National Reference Center for Imported Ma-laria Study Group. Severe imported Plasmodium falciparum ma¬laria, France, 1996-2003. Emerg Infect Dis 2011; 17: 807–13.

Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: Se¬vere malaria. Crit Care 2003; 7(4): 315–23.

Kain KC, Harrington MA, Tennyson S, Keystone JS. Imported ma-laria: prospective analysis of problems in diagnosis and man-agement. Clin Infect Dis 1998; 27(1): 142–9.

Mali S, Kachur SP, Arguin PM. Division of Parasitic Diseases and Malaria, Center for Global Health; Centers for Disease Control and Prevention (CDC), Malaria surveillance - United States, 2010. MMWR Surveill Summ 2012; 61(2): 1–17.

Phillips A, Bassett P, Zeki S, Newman S, Pasvol G. Risk factors for severe disease in adults with falciparum malaria. Clin In-fect Dis 2009; 48(7): 871–8.

Schwake L, Streit JP, Edler L, Encke J, Stremmel W, Junghanss T. Early treatment of imported falciparum malaria in the inter-mediate and intensive care unit setting: an 8-year single-center retrospective study. Crit Care 2008; 12(1): R22.

Mueller I, Galinski MR, Baird KJ, Carlton JM, Kochar DK, Alonso PL, et al. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis 2009; 9(9): 555–66.

Baird KJ. Neglect of Plasmodium vivax malaria. Trends Parasi-tol 2007; 23(11): 533–9.

Sharma A, Khanduri U. How benign is benign tertian malaria? J Vector Borne Dis 2009; 46(2): 141–4.

Singh H, Parakh A, Basu S, Rath B. Plasmodium vivax malaria: is it actually benign? J Infect Public Health 2011; 4(2): 91–5.

González A, Nicolás JM, Muñoz J, Castro P, Mas J, Valls ME, et al. Severe imported malaria in adults: retrospective study of 20 cases. Am J Trop Med Hyg 2009; 81(4): 595–9.

Dondorp AM, Lee SJ, Faiz MA, Mishra S, Price R, Tjitra E, et al. The relationship between age and the manifestations of and mortality associated with severe malaria. Clin Infect Dis 2008; 47(2): 151–7.

Newman RD, Parise ME, Barber AM, Steketee RW. Malaria-re-lated deaths among U.S. travelers, 1963-2001. Ann Intern Med 2004; 141(7): 547–55.

Rabe C, Paar WD, Knopp A, Münch J, Musch A, Rockstroh J, et al. Malaria in the emergency room. Results of the emergency treatment of 137 patients with symptomatic malaria. Dtsch Med Wochenschr 2005; 130(4): 145–9.

Muhlberger N, Jelinek T, Behrens RH, Gjorup I, Coulaud JP, Cler-inx J. Surveillance importierter Infektionen in Deutschland Sur¬veillance Networks . Age as a Risk Factor for Severe Mani-fes¬tations and Fatal Outcome of Falciparum Malaria in Euro-pean Patients: Observations from TropNetEurop and SIM-PID Sur¬veillance Data. Clin Infect Dis 2003; 36(8): 990–5.

Schwartz E, Sadetzki S, Murad H, Raveh D. Age as a risk factor for severe Plasmodium falciparum malaria in nonimmune pa-tients. Clin Infect Dis 2001; 33(10): 1774–7.

Gjørup IE, Rønn A. Malaria in elderly nonimmune travelers. J Travel Med 2002; 9(2): 91–3.

Koh KH, Chew PH, Kiyu A. A retrospective study of malaria in-fections in an intensive care unit of a general hospital in Ma-laysia. Singapore Med J 2004; 45(1): 28–36.

Legros F, Bouchaud O, Ancelle T, Arnaud A, Cojean S, le Bras J, et al. The French National Reference Centers for Imported and Autochthonous Malaria Epidemiology and Chemosensi-tivity Network. Risk factors for imported fatal Plasmodium falcipa¬rum malaria, France, 1996-2003. Emerg Infect Dis 2007; 13(6) :883–8.

Krause G, Schöneberg I, Altmann D, Stark K. Chemoprophylaxis and malaria death rates. Emerging Infect Dis 2006; 12(3): 447–51.

Bruneel F, Hocqueloux L, Alberti C, Wolff M, Chevret S, Bédos J, et al. The clinical spectrum of severe imported falciparum ma-laria in the intensive care unit: report of 188 cases in adults. Am J Respir Crit Care Med 2003; 167(5): 684–9.

Oliveira-Ferreira J, Lacerda MV, Brasil P, Ladislau JL, Tauil PL, Daniel-Ribeiro CT. Malaria in Brazil: an overview. Malar J 2010; 9(1): 115.

Matteelli A, Colombini P, Gulletta M, Castelli F, Carosi G. Epi-demi¬ological features and case management practices of im-ported malaria in northern Italy 1991-1995. Trop Med Int Health 1999; 4(10): 653–7.

Lyke KE, Burges R, Cissoko Y, Sangare L, Dao M, Diarra I, et al. Serum levels of the proinflammatory cytokines interleukin-1 beta (IL-1beta), IL-6, IL-8, IL-10, tumor necrosis factor al-pha, and IL-12(p70) in Malian children with severe Plasmodi-um falciparum malaria and matched uncomplicated malaria or healthy controls. Infect Immun 2004; 72(10): 5630–7.

Jennings RM, de Souza BJ, Todd JE, Armstrong M, Flanagan KL, Ri¬ley EM, et al. Imported Plasmodium falciparum malaria: are patients originating from disease-endemic areas less likely to develop severe disease? A prospective, observational study. Am J Trop Med Hyg 2006; 75(6): 1195–9.

Akanmori BD, Kurtzhals JA, Goka BQ, Adabayeri V, Ofori MF, Nkrumah FK, et al. Distinct patterns of cytokine regulation in discrete clinical forms of Plasmodium falciparum malaria. Eur Cytokine Netw 2000; 11(1): 113–8.

Idro R, Jenkins NE, Newton CR. Pathogenesis, clinical features, and neurological outcome of cerebral malaria. Lancet Neurol 2005; 4(12): 827–40.

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2021/02/12
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