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Clinical spectrum of uncomplicated malaria in semi-immune Amazonians: beyond the " symptomatic " vs " asymptomatic " dichotomy
Silva-Nunes, Mônica da; Ferreira, Marcelo U.
Afiliação
  • Silva-Nunes, Mônica da; Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo. BR
  • Ferreira, Marcelo U; Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo. BR
Mem. Inst. Oswaldo Cruz ; 102(3): 341-348, June 2007. tab, graf
Article em En | LILACS | ID: lil-452512
Biblioteca responsável: BR1.1
ABSTRACT
We analyzed prospectively 326 laboratory-confirmed, uncomplicated malarial infections (46.3 percent due to Plasmodium vivax, 35.3 percent due to P. falciparum, and 18.4 percent mixed-species infections) diagnosed in 162 rural Amazonians aged 5-73 years. Thirteen symptoms (fever, chills, sweating, headache, myalgia, arthralgia, abdominal pain, nausea, vomiting, dizziness, cough, dyspnea, and diarrhea) were scored using a structured questionnaire. Headache (59.8 percent), fever (57.1 percent), and myalgia (48.4 percent) were the most frequent symptoms. Ninety-six (29.4 percent) episodes, all of them diagnosed during cross-sectional surveys of the whole study population (96.9 percent by molecular technique only), were asymptomatic. Of 93 symptom-less infections left untreated, only 10 became symptomatic over the next two months following diagnosis. Fever was perceived as " intense " in 52.6 percent of 230 symptomatic malaria episodes, with no fever reported in 19.1 percent episodes although other symptoms were present. We found significant differences in the prevalence and perceived intensity of fever and other clinical symptoms in relation to parasite load at the time of diagnosis and patient's age, cumulative exposure to malaria, recent malaria morbidity, and species of malaria parasite. These factors are all likely to affect the effectiveness of malaria control strategies based on active or passive detection of febrile subjects in semi-immune populations.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Malária Falciparum Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Aged80 / Animals / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Mem. Inst. Oswaldo Cruz Assunto da revista: MEDICINA TROPICAL / PARASITOLOGIA Ano de publicação: 2007 Tipo de documento: Article / Project document País de afiliação: Brasil País de publicação: Brasil
Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Malária Falciparum Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Aged80 / Animals / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Mem. Inst. Oswaldo Cruz Assunto da revista: MEDICINA TROPICAL / PARASITOLOGIA Ano de publicação: 2007 Tipo de documento: Article / Project document País de afiliação: Brasil País de publicação: Brasil