Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate.
Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate.
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DOI：
10.1186/1475-2875-11-284
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发表时间：
2012-08-20
期刊：
影响因子：
3
通讯作者：
Yeo TW
中科院分区：
文献类型：
--
作者：
Rajahram GS;Barber BE;William T;Menon J;Anstey NM;Yeo TW
在马来西亚的沙巴，猴寄生虫诺氏疟原虫被认为是严重和致命的人类疟疾的常见原因，但在形态上与三日疟原虫无法区分，并且仍然通常被报告为三日疟原虫，尽管该物种在沙巴很少。自2008年12月起，沙巴卫生署建议对所有严重疟疾病例进行静脉注射青蒿琥酯，并将其转诊至综合医院。本文回顾了所有疟疾死亡在沙巴随后引进这些措施。在马来西亚，疟疾死亡报告是强制性的。审查了2010-2011年期间报告的疟疾死亡详情，以确定每种疟原虫的比例。比较了由每种疟疾引起的严重疟疾的人口统计学、临床表现和管理。报告了14例疟疾死亡病例，包括7例恶性疟原虫、6例诺氏疟原虫和1例间日疟原虫（均经聚合酶链反应证实）。在6例诺氏疟原虫死亡病例中，5例可归因于诺氏疟疾，1例可归因于诺氏疟原虫相关肠杆菌败血症。直接归因于诺氏疟原虫死亡的患者（N = 5）年龄大于恶性疟原虫患者（中位年龄51 [IQR 50-65] vs 22 [IQR 9-55]岁，p = 0.06）。致死性诺氏疟原虫的并发症包括呼吸窘迫（N = 5，100%）、低血压（N = 4，80%）和肾衰竭（N = 4，80%）。通过显微镜检查，所有诺氏疟原虫患者均报告为三日疟原虫。只有两个严重的诺氏疟疾的五名患者介绍接受立即肠外抗疟治疗。患有间日疟原虫相关重度疾病的患者未接受肠外治疗。相比之下，七名严重恶性疟疾患者中有六名接受了立即胃肠外治疗。诺氏疟原虫是负责，无论是直接或通过革兰氏阴性菌血症，几乎一半的疟疾死亡在沙巴。严重的非恶性疟疾患者不太可能立即接受肠外治疗。这突出表明，在沙巴，需要将显微镜诊断的三日疟原虫报告为诺氏疟原虫，以提高对这种潜在致命种属的识别和管理。临床医生需要更好地了解非恶性疟原虫种属感染严重和致命疟疾的可能性，以及需要立即静脉注射青蒿琥酯治疗所有严重疟疾。
The simian parasite Plasmodium knowlesi is recognized as a common cause of severe and fatal human malaria in Sabah, Malaysia, but is morphologically indistinguishable from and still commonly reported as Plasmodium malariae, despite the paucity of this species in Sabah. Since December 2008 Sabah Department of Health has recommended intravenous artesunate and referral to a general hospital for all severe malaria cases of any species. This paper reviews all malaria deaths in Sabah subsequent to the introduction of these measures. Reporting of malaria deaths in Malaysia is mandatory. Details of reported malaria deaths during 2010-2011 were reviewed to determine the proportion of each Plasmodium species. Demographics, clinical presentations and management of severe malaria caused by each species were compared. Fourteen malaria deaths were reported, comprising seven Plasmodium falciparum, six P. knowlesi and one Plasmodium vivax (all PCR-confirmed). Of the six P. knowlesi deaths, five were attributable to knowlesi malaria and one was attributable to P. knowlesi-associated enterobacter sepsis. Patients with directly attributable P. knowlesi deaths (N = 5) were older than those with P. falciparum (median age 51 [IQR 50-65] vs 22 [IQR 9-55] years, p = 0.06). Complications in fatal P. knowlesi included respiratory distress (N = 5, 100%), hypotension (N = 4, 80%), and renal failure (N = 4, 80%). All patients with P. knowlesi were reported as P. malariae by microscopy. Only two of five patients with severe knowlesi malaria on presentation received immediate parenteral anti-malarial treatment. The patient with P. vivax-associated severe illness did not receive parenteral treatment. In contrast six of seven patients with severe falciparum malaria received immediate parenteral treatment. Plasmodium knowlesi was responsible, either directly or through gram-negative bacteraemia, for almost half of malaria deaths in Sabah. Patients with severe non-falciparum malaria were less likely to receive immediate parenteral therapy. This highlights the need in Sabah for microscopically diagnosed P. malariae to be reported as P. knowlesi to improve recognition and management of this potentially fatal species. Clinicians need to be better informed of the potential for severe and fatal malaria from non-falciparum species, and the need to treat all severe malaria with immediate intravenous artesunate.
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影响因子：
3
作者：
Daneshvar C;Davis TM;Cox-Singh J;Rafa'ee MZ;Zakaria SK;Divis PC;Singh B
通讯作者：
Singh B
影响因子：
3
作者：
Cox-Singh J;Hiu J;Lucas SB;Divis PC;Zulkarnaen M;Chandran P;Wong KT;Adem P;Zaki SR;Singh B;Krishna S
通讯作者：
Krishna S
DOI：
10.1086/597414
发表时间：
2009-04-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Putaporntip C;Hongsrimuang T;Seethamchai S;Kobasa T;Limkittikul K;Cui L;Jongwutiwes S
通讯作者：
Jongwutiwes S
DOI：
10.1016/s0035-9203(99)90024-x
发表时间：
1999-05-01
影响因子：
2.2
作者：
Berkley, J;Mwarumba, S;Marsh, K
通讯作者：
Marsh, K
影响因子：
11.8
作者：
Jiang, Ning;Chang, Qiaocheng;Chen, Qijun
通讯作者：
Chen, Qijun