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Cited by 166Malaria Research and ControlTravel-related health issuesMosquito-borne diseases and control

Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

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Lacerda, Marcus VG, Mourão, Maria PG, Alexandre, Márcia AA, Siqueira, André M, Magalhães, Belisa ML, Martinez-Espinosa, Flor E, Santana Filho, Franklin S, Brasil, Patrícia +6 more·2012·Malaria Journal
DOI 10.1186/1475-2875-11-12PMC PMC3268102
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Abstract

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out.

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  • Severe maternal malaria can result in cerebral malaria, associated neurologic sequelae, malarial anemia, respiratory distress, hypoglycemia, and other pregnancy-related complications.

    “Additionally, other studies have reported that severe maternal malaria can result in cerebral malaria, associated neurologic sequelae, malarial anemia, respiratory distress, hypoglycemia, and other pregnancy-related complications [131, 169, 171–173].”

    From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [171]

    The Background section on pregnancy-associated malaria reports maternal anaemia, hypoglycaemia, and pregnancy complications including low birth weight, bleeding, abortion, and premature delivery. The sections on neurological syndrome and respiratory distress discuss those conditions in malaria generally, but do not establish cerebral malaria, neurological sequelae, or malaria-caused respiratory distress in pregnant women. Page numbers are not available in our copy. (LLM, conf=0.86)

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1 of the 136 references couldn’t be matched to a known paper.

Research works printed but not linked: 18

  1. [22]Chagas C Hematological studies of impaludism MD Thesis 1903
  2. [60]Moura ACL Balbo BEP Cancela ALE Betti MH Heneine RAD Zumpano JF Death due to P. vivax in a non-endemic area [abstract] Rev Soc Bras Med Trop 2002 35 369
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  4. [80]Urbaez-Brito JD Clinical and laboratorial characteristics of human malaria and hepatitis B virus association Master Dissertation 1995 Tropical Medicine Department University of Brasília
  5. [81]Alecrim MGC Clinical aspects, resistance and parasitary polymorphism of Plasmodium vivax malaria in Manaus PhD Thesis 2000 Tropical Medicine Department University of Brasília
  6. [82]Neves JJO Malaria in Pará: study of the clinical and laboratorial picture in infections caused by Plasmodium vivax Master Dissertation 2002
  7. [83]Marques HO Hemostasis disturbances in patients with malaria Master Dissertation 2004 Hematology Department Federal University of São Paulo
  8. [84]Oliveira MS Hematological characterization of children with vivax malaria diagnosed and treated in the Fundação de Medicina Tropical do Amazonas Master Dissertation 2004 Health Sciences School University of the Amazonas State
  9. [85]Silva IBA Vivax malaria: clinical and laboratorial manifestations related to TNF-alpha PhD Thesis 2004
  10. [86]Raposo CCBS Vivax malaria in Maranhão: epidemiological and clinical aspects Master Dissertation 2006 Tropical Medicine Deprtment University of Brasília
  11. [87]Pereira MSS Study of malaria in pregnant and puerperal women in a public maternity in Manaus from 1999 to 2004 Master Dissertation 2006 Health Sciences School Federal University of Amazonas
  12. [88]Guerreiro NSV Clinical and epidemiological study of Plasmodium vivax malaria in the State of Amapá Master Dissertation 2006
  13. [89]Lacerda MVG Clinical manifestations and pathogenesis of malarial thrombocytopenia PhD Thesis 2007 Tropical Medicine Department University of Brasília
  14. [90]Silva SBR Evaluation of frequency and factors associated to thrombocytopenia caused by Plasmodium vivax Master Dissertation 2009
  15. [91]Fragoso SCP Study of 17 cases of autopsies from patients with the diagnosis of vivax malaria in a reference center in the Brazilian Amazon Master Dissertation 2010 Health Sciences School University of the Amazonas State
  16. [92]Lança EFC Children under 14 years with malaria admitted to Intensive Care Units in the Brazilian Amazon: a case-control study with Plasmodium vivax patients Master Dissertation 2011 Health Sciences School University of the Amazonas State
  17. [108]Lakhkar BB Babu S Shenoy V DIC in vivax malaria Indian Pediatr 1996 33 971 972 9141839
  18. [146]Ventura AM Pinto AY Silva RS Calvosa VS Silva Filho MG Souza JM Plasmodium vivax malaria in children and adolescents - epidemiological, clinical and laboratory features J Pediatr (Rio J) 1999 75 187 194 14685540

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Authors
Lacerda, M. V., Mourão, M. P., Alexandre, M. A., Siqueira, A. M., Magalhães, B. M., Martinez-Espinosa, F. E., Santana Filho, F. S., Brasil, P., Ventura, A. M., Tada, M. S., Couto, V. S., Silva, A. R., Silva, R. S., & Alecrim, M. G.
Affiliations
  • Fundação de Medicina Tropical (BR)
  • Fundação Oswaldo Cruz (BR)
  • Universidade Federal do Maranhão (BR)
  • Universidade Federal do Acre (BR)
Corresponding author
Lacerda, Marcus VG
ORCID
Venue
Malaria Journal
Publisher
Springer Science and Business Media LLC
Published
2012-01-09
Volume
11
Issue
1
Pages
12-12
ISSN
1475-2875 (ISSN-L)
DOI
10.1186/1475-2875-11-12
PMC
PMC3268102
OpenAlex
W2138295263
Cited by
158
References
136
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 9 · 2021: 10 · 2020: 16 · 2019: 9 · 2018: 7 · 2017: 11 · 2016: 19 · 2015: 20 · 2014: 20 · 2013: 17 · 2012: 10
FWCI
3.30
Type
journal article
Language
en
Open access
Licence
Locations
  • Malaria Journal (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Americanae (AECID Library) (submittedVersion, other-oa)
  • Arca - Repositório Institucional da Fiocruz (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
Funders
  • Fundação de Amparo à Pesquisa do Estado de São Paulo
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico
  • Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro
  • Fundação de Amparo à Pesquisa do Estado de Minas Gerais
  • Fundação de Amparo à Pesquisa do Estado do Amazonas
  • Fundação de Amparo à Pesquisa do Estado de Mato Grosso
  • Ministério da Saúde
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Travel-related health issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
Keywords
Plasmodium vivax, severe malaria, clinical features, anemia, thrombocytopenia, jaundice, acute respiratory distress syndrome, malaria in pregnancy, comorbidities, publication bias, Brazilian Amazon, travellers
MeSH terms
Brazil, Female, Geography, Humans, Male, Plasmodium vivax, Pregnancy, Pregnancy Complications, Infectious, Survival Analysis, Malaria, Vivax

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