Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique
Background.Severe falciparum malaria with human immunodeficiency virus (HIV) coinfection is common in settings with a high prevalence of both diseases, but there is little information on whether HIV affects the clinical presentation and outcome of severe malaria.Methods.HIV status was assessed prosp...
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th-mahidol.145912018-06-11T12:03:30Z Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique Ilse C E Hendriksen Josefo Ferro Pablo Montoya Kajal D. Chhaganlal Amir Seni Ermelinda Gomes Kamolrat Silamut Sue J. Lee Marcelino Lucas Kesinee Chotivanich Caterina I. Fanello Nicholas P J Day Nicholas J. White Lorenz Von Seidlein Arjen M. Dondorp Mahidol University University of Oxford Hospital Central da Beira Health Alliance International University of Washington, Seattle Ministerio da Saude Menzies School of Health Research Medicine Background.Severe falciparum malaria with human immunodeficiency virus (HIV) coinfection is common in settings with a high prevalence of both diseases, but there is little information on whether HIV affects the clinical presentation and outcome of severe malaria.Methods.HIV status was assessed prospectively in hospitalized parasitemic adults and children with severe malaria in Beira, Mozambique, as part of a clinical trial comparing parenteral artesunate versus quinine (ISRCTN50258054). Clinical signs, comorbidity, complications, and disease outcome were compared according to HIV status.Results.HIV-1 seroprevalence was 11 (74/655) in children under 15 years and 72 (49/68) in adults with severe malaria. Children with HIV coinfection presented with more severe acidosis, anemia, and respiratory distress, and higher peripheral blood parasitemia and plasma Plasmodium falciparum histidine-rich protein-2 (PfHRP2). During hospitalization, deterioration in coma score, convulsions, respiratory distress, and pneumonia were more common in HIV-coinfected children, and mortality was 26 (19/74) versus 9 (53/581) in uninfected children (P < . 001). In an age-and antimalarial treatment-adjusted logistic regression model, significant, independent predictors for death were renal impairment, acidosis, parasitemia, and plasma PfHRP2 concentration. Conclusions.Severe malaria in HIV-coinfected patients presents with higher parasite burden, more complications, and comorbidity, and carries a higher case fatality rate. Early identification of HIV coinfection is important for the clinical management of severe malaria. © 2012 The Author. 2018-06-11T05:03:30Z 2018-06-11T05:03:30Z 2012-10-15 Article Clinical Infectious Diseases. Vol.55, No.8 (2012), 1144-1153 10.1093/cid/cis590 15376591 10584838 2-s2.0-84866725475 https://repository.li.mahidol.ac.th/handle/123456789/14591 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84866725475&origin=inward |
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Medicine Ilse C E Hendriksen Josefo Ferro Pablo Montoya Kajal D. Chhaganlal Amir Seni Ermelinda Gomes Kamolrat Silamut Sue J. Lee Marcelino Lucas Kesinee Chotivanich Caterina I. Fanello Nicholas P J Day Nicholas J. White Lorenz Von Seidlein Arjen M. Dondorp Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique |
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Background.Severe falciparum malaria with human immunodeficiency virus (HIV) coinfection is common in settings with a high prevalence of both diseases, but there is little information on whether HIV affects the clinical presentation and outcome of severe malaria.Methods.HIV status was assessed prospectively in hospitalized parasitemic adults and children with severe malaria in Beira, Mozambique, as part of a clinical trial comparing parenteral artesunate versus quinine (ISRCTN50258054). Clinical signs, comorbidity, complications, and disease outcome were compared according to HIV status.Results.HIV-1 seroprevalence was 11 (74/655) in children under 15 years and 72 (49/68) in adults with severe malaria. Children with HIV coinfection presented with more severe acidosis, anemia, and respiratory distress, and higher peripheral blood parasitemia and plasma Plasmodium falciparum histidine-rich protein-2 (PfHRP2). During hospitalization, deterioration in coma score, convulsions, respiratory distress, and pneumonia were more common in HIV-coinfected children, and mortality was 26 (19/74) versus 9 (53/581) in uninfected children (P < . 001). In an age-and antimalarial treatment-adjusted logistic regression model, significant, independent predictors for death were renal impairment, acidosis, parasitemia, and plasma PfHRP2 concentration. Conclusions.Severe malaria in HIV-coinfected patients presents with higher parasite burden, more complications, and comorbidity, and carries a higher case fatality rate. Early identification of HIV coinfection is important for the clinical management of severe malaria. © 2012 The Author. |
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Mahidol University |
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Mahidol University Ilse C E Hendriksen Josefo Ferro Pablo Montoya Kajal D. Chhaganlal Amir Seni Ermelinda Gomes Kamolrat Silamut Sue J. Lee Marcelino Lucas Kesinee Chotivanich Caterina I. Fanello Nicholas P J Day Nicholas J. White Lorenz Von Seidlein Arjen M. Dondorp |
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Article |
author |
Ilse C E Hendriksen Josefo Ferro Pablo Montoya Kajal D. Chhaganlal Amir Seni Ermelinda Gomes Kamolrat Silamut Sue J. Lee Marcelino Lucas Kesinee Chotivanich Caterina I. Fanello Nicholas P J Day Nicholas J. White Lorenz Von Seidlein Arjen M. Dondorp |
author_sort |
Ilse C E Hendriksen |
title |
Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique |
title_short |
Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique |
title_full |
Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique |
title_fullStr |
Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique |
title_full_unstemmed |
Diagnosis, clinical presentation, and in-hospital mortality of severe malaria in HIV-coinfected children and adults in mozambique |
title_sort |
diagnosis, clinical presentation, and in-hospital mortality of severe malaria in hiv-coinfected children and adults in mozambique |
publishDate |
2018 |
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https://repository.li.mahidol.ac.th/handle/123456789/14591 |
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1763491048670101504 |