A descriptive study of 16 severe Plasmodium vivax cases from three municipalities of Colombia between 2009 and 2013

Abstract

Background: Plasmodium vivax, the most geographically distributed cause of malaria, accounts for more than 70 of cases in the Americas. In Colombia, P. vivax was responsible for 67.3% of cases in the last five years. Despite viva malaria impact worldwide, historically it has been neglected and considered to be a benign disease. In the las decade medical literature reports have emerged countering this benign outlook. This study pretends to describ the clinical and paraclinical profile of severe vivax malaria cases hospitalized in Tumaco, Cali, Buenaventura betwee 2009 and 2013, to contribute to the knowledge regarding the behaviour and clinical expression of this disease Methods: This is a descriptive, retrospective case-series study of 16 severe malaria vivax cases, hospitalized betwee 2009 and 2013, in Colombian municipalities of Tumaco, Buenaventura and Cali. Severe malaria vivax cases wer defined using criteria adapted from the national guidelines. Descriptive analyses of reason for consultation, signs an symptoms, diagnosis, treatment, paraclinical characteristics, complications, and time hospitalized, were conducted Results: Sixteen cases of severe P. vivax were analysed. Fever, chills and headache were shown to be the mai admission symptoms. Elevation of total bilirubin levels in 18.75%, and severe thrombocytopaenia in 25% of cases wer the main complications presented during hospitalization. All cases responded to treatment, there were no deaths Conclusions: The following questions derived from this study could be the basis for future research: 1) Does the tim to consultation have an impact on the number of days hospitalized and how cases progress during hospitalization 2) Are the severity criteria in WHO guidelines sensitive enough to be used in clinical practice compared to nationa guidelines, and 3) How does malnutrition contribute to anaemia in malaria-endemic regions.