Plasmodium vivax: Clinical Spectrum, Risk Factors and Pathogenesis - Advances in Parasitology - page 150

CHAPTER THREE

Plasmodium vivax : Clinical
Spectrum, Risk Factors
and Pathogenesis

Nicholas M. Anstey * , † , 1 , Nicholas M. Douglas * , † ,
Jeanne R. Poespoprodjo ‡ , § , Ric N. Price * , † , ¶
*Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin,
Australia
† Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Australia
‡ Papuan Community Health and Development Foundation, Timika, Papua, Indonesia
§ Department of Pediatrics, Timika General Hospital, Timika, Papua, Indonesia
¶ Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford,
Oxford, UK
1 Corresponding author: Nicholas M. Anstey, Global Health Division, Menzies School of Health Research,
PO Box 41096, Casuarina, Darwin, NT 08111, Australia. E-mail: [e-mail]

Contents
1. Introduction

153

2. Pre-patentandIncubationPeriods 154

3. SymptomsandSignsofVivaxMalaria 155

3.1. Fever 155

3.2. OtherSymptomsandSigns 156

3.3. MalnutritionandImpairedGrowth 157

3.4. ImpairedSchoolPerformance 157

4. ClinicalIllnessRequiringHospitalisation 158

5. SevereMalaria 158

6. RiskofSevereDiseaseandDeath 160

7. VulnerableGroups 161

7.1. YoungChildren 161

7.2. Malnutrition 161

7.3. HIVInfection 162

7.4. OtherCo-morbidities 162

8. SpeciicClinicalManifestationsofSevereVivaxMalaria 163

8.1. SevereMalariainAdults 163

8.1.1. Severe anaemia 163

8.1.2. Acute lung injury and respiratory distress 165

8.1.3. Coma and other vivax-associated neurological complications 165

8.1.4. Acute kidney injury 167

8.1.5. Shock and multiorgan dysfunction 168

8.1.6. Bacterial co-infection and bacteraemia 169