The online version of this article (https://doi.org/10.1186/s12936-017-2143-y) contains supplementary material, which is available to authorized users.
Respiratory complications are uncommon, but often life-threatening features of Plasmodium vivax malaria. This study aimed to estimate the prevalence and lethality associated with such complications among P. vivax malaria patients in a tertiary hospital in the Western Brazilian Amazon, and to identify variables associated with severe respiratory complications, intensive care need and death. Medical records from 2009 to 2016 were reviewed aiming to identify all patients diagnosed with P. vivax malaria and respiratory complications. Prevalence, lethality and risk factors associated with WHO defined respiratory complications, intensive care need and death were assessed.
A total of 587 vivax malaria patients were hospitalized during the study period. Thirty (5.1%) developed respiratory complications. Thirteen (43.3%) developed severe respiratory complications, intensive care was required for 12 (40%) patients and 5 (16.6%) died. On admission, anaemia and thrombocytopaenia were common findings, whereas fever was unusual. Patients presented different classes of parasitaemia and six were aparasitaemic on admission. Time to respiratory complications occurred after anti-malarials administration in 18 (60%) patients and progressed very rapidly. Seventeen patients (56.7%) had comorbidities and/or concomitant conditions, which were significantly associated to higher odds of developing severe respiratory complications, need for intensive care and death (p < 0.05).
Respiratory complications were shown to be associated with significant mortality in this population. Patients with comorbidities and/or concomitant conditions require special attention to avoid this potential life-threatening complication.
Additional file 1. STROBE Statement—checklist of items that should be included in reports of observational studies.
Additional file 2: Table S1. Univariate analysis for risk factors for severe respiratory complications.
Additional file 3: Table S2. Univariate analysis for risk factors for intensive care need.
Additional file 4: Table S3. Univariate analysis for risk factors for final outcome.
Additional file 5: Table S4. AUC of ROC depicting discriminatory performance of baseline laboratorial data according to outcome.
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- Are respiratory complications of Plasmodium vivax malaria an underestimated problem?
André Alexandre Gomes
José Evelio Albornoz Zerpa
André Machado Siqueira
Maria Graças Costa Alecrim
Wuelton Marcelo Monteiro
Marcus Vinícius Guimarães Lacerda
- BioMed Central
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