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Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature
Open accessAbstract
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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“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]
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Metadata
- 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
- Venue
- Malaria Journal
- Published
- 2012-01-09
- Volume
- 11
- Issue
- 1
- Pages
- 12-12
- ISSN
- 1475-2875 (ISSN-L)
- 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
- gold
- doi.org
- 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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