Biology Reference
In-Depth Information
have described coma in association with multiorgan dysfunction (
Kochar
et al., 2005
,
2009
). A post-malarial neurological syndrome with tremor and
myoclonus has also been reported after recovery from coma associated with
PCR-confirmed
P. vivax
monoinfection (
Lampah et al., 2011
), similar to
that occasionally seen following coma in falciparum malaria (
Nguyen et al.,
1996
).
Other, rarer, neurological complications reported in association with
P.
vivax
infection include facial diplegia, both during (
Sim et al., 2010
) and fol-
lowing (
Kochar et al., 2007
) recovery from febrile illness, acute inflammatory
polyneuropathy (
Chakravarty et al., 2004
), acute disseminated encephalomy-
elitis (
Koibuchi et al., 2003
) and anterior ischemic optic neuropathy (
Flower
et al., 2011
). Retinopathy is common in severe falciparum malaria, particu-
larly in cerebral malaria (
Beare et al., 2006
). While not seen in a series of
uncomplicated adult vivax malaria in Bangladesh (
Abu Sayeed et al., 2011
),
cases of retinal haemorrhages in pure vivax malaria have been described else-
where without central nervous system complications (
Lee et al., 2010
;
Choi
et al., 2004
). A further case of retinal haemorrhages and coma attributed to
P.
vivax
had a mixed infection with
P. falciparum
, which may have been respon-
sible for the complications reported (
Biswas et al., 1996
).
8.1.4. Acute kidney injury
AKI has now been reported in a large number of series of adult vivax
malaria (
Kochar et al., 2005
,
2009
;
Andrade et al., 2010
;
Alexandre et al.,
2010
;
Chung et al., 2008
;
Kute et al., 2012
;
Sinha et al., 2012
). There appear
to be geographic differences in risk and severity, with little or no vivax-
associated AKI being reported in returned travellers (
Tan et al., 2008
) or
from some vivax-endemic areas, such as Thailand (
Luxemburger et al., 1997
;
Piyaphanee et al., 2007
) and Vietnam (
Hien et al., 1996
). AKI is reported
but rarely severe in Korea (
Chung et al., 2008
). Across northern India, severe
dialysis-requiring AKI and/or AKI-related death is increasingly reported,
including Rajasthan (
Kochar et al., 2005
,
2009
), Gujarat (
Kute et al., 2012a
,
2012b
), Delhi (
Sinha et al., 2012
) and Uttar Pradesh (
Prakash et al., 2003
),
with only the Rajasthan series being PCR-confirmed
P. vivax
monoinfec-
tion. In Gujarat, the proportion of all malaria-associated AKI due to micros-
copy-diagnosed
P. vivax
is reported to have risen from 2% (
Kanodia et al.,
2010
) to 12% (
Kute et al., 2012b
) by 2010-2011. AKI in PCR-confirmed
monoinfection has also been reported from Brazil (
Andrade et al., 2010b
;
Alexandre et al., 2010
;
Lacerda et al., 2012
). No population-based data on
risk of AKI has been reported from any region.
