Biology Reference
In-Depth Information
(
Price et al., 2009
;
Tjitra et al., 2008
;
Nurleila et al., 2012
;
Manning
et al., 2011
;
Poespoprodjo et al., 2009
;
Genton et al., 2008
) and low birth
weight (
Nosten et al., 1999
;
Poespoprodjo et al., 2008
;
Rijken et al.,
2012a
).
Severe vivax malaria has been reported in case series from Indonesia
(
Barcus et al., 2007
;
Tjitra et al., 2008
;
Nurleila et al., 2012
;
Lampah et al.,
2011
), Papua New Guinea (
Manning et al., 2011
;
Genton et al., 2008
),
India (
Kochar et al., 2005
,
2009
,
2010
;
Yadav et al., 2012
;
Kaushik et al.,
2012
;
Sharma et al., 2012
;
Naha et al., 2012
;
Tanwar et al., 2011
;
Kapoor and
Gupta, 2012
;
Jat et al., 2012
), Thailand (
Luxemburger et al., 1997
),Venezuela
(
Rodriguez-Morales et al., 2008
), Brazil (
Andrade et al., 2010b
;
Alexandre
et al., 2010
;
Lacerda et al., 2012
;
Lanca et al., 2012
), Malaysia (Barber et al.,
2012) and Sudan (
Mahgoub et al., 2012
), with most, but not all, series
including fatal cases. These case series include a variety of severe manifesta-
tions associated with
P. vivax
infection, including severe anaemia, respira-
tory distress and acute lung injury (ALI), acute kidney injury (AKI), splenic
rupture, jaundice, coma, multiorgan dysfunction and shock. Each of these
syndromes is reviewed separately below.
Most recent series report PCR-exclusion of mixed infection with
P.
falciparum
, however, in common with most series of falciparum malaria,
investigation for concurrent infections or co-morbidities has been mostly
incomplete or omitted. The most convincing evidence for
P. vivax
being
a major contributory factor is apparent for severe anaemia (
Price et al.,
2009
), acute respiratory distress syndrome (ARDS) (
Tan et al., 2008
;
Vale-
cha et al., 2009
) and, increasingly, AKI (
Chung et al., 2008
;
Kute et al.,
2012
;
Sinha et al., 2012
). For some of the other reported severe syn-
dromes, the extent to which they are attributable to
P. vivax
is not yet
clear. For these syndromes, acute and chronic infectious and non-infec-
tious co-morbidities are likely to be important contributing factors or
alternative causes (
Price et al., 2009
;
Kitchen, 1949b
;
Lacerda et al., 2012
;
Lampah et al., 2011
;
Anstey et al., 2009
;
Rajahram et al., 2012
). How-
ever, the presence of co-morbidities does not necessarily negate a crucial
role that
P. vivax
may play in the pathophysiology of the disease. In
P.
falciparum
infection, malnutrition, HIV and invasive bacterial infections
are now recognized as being biologically associated with severe disease
due to falciparum malaria rather than just being alternative diagnoses in
co-incidentally parasitized patients in falciparum-endemic areas (
Berkley
et al., 2009
). Similar relationships, including other co-morbidities, may
apply with
P. vivax
but require more systematic study.
