TY - JOUR 
A1 - Val, Fernando
AU - Avalos, Sara
AU - Gomes, André Alexandre
AU - Albornoz Zerpa, José Evelio
AU - Fontecha, Gustavo
AU - Machado Siqueira, André
AU - Bassat, Quique
AU - Costa Alecrim, Maria Graças
AU - Monteiro, Wuelton Marcelo
AU - Guimarães Lacerda, Marcus Vinícius
T1 - Are respiratory complications of Plasmodium vivax malaria an underestimated problem?
Y1 - 2017
SN - 1475-2875
UR - http://hdl.handle.net/11268/7060
AB - Background:
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.

Results:
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).

Conclusion:
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.

Electronic supplementary material:
The online version of this article (10.1186/s12936-017-2143-y) contains supplementary material, which is available to authorized users.
KW - Aparato respiratorio -- Enfermedades
KW - Paludismo
KW - Cuidados intensivos
KW - Aparato respiratorio
KW - Malaria
KW - Tratamiento médico
LA - eng
ER -