P. vivax malaria and dengue fever co-infection: a cross-sectional study in the Brazilian Amazon.

Autor: Magalhães BM; Universidade do Estado do Amazonas, Manaus, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Siqueira AM; Universidade do Estado do Amazonas, Manaus, Brazil., Alexandre MA; Universidade do Estado do Amazonas, Manaus, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Souza MS; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Gimaque JB; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Bastos MS; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Figueiredo RM; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Melo GC; Universidade do Estado do Amazonas, Manaus, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Lacerda MV; Universidade do Estado do Amazonas, Manaus, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil., Mourão MP; Universidade do Estado do Amazonas, Manaus, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2014 Oct 23; Vol. 8 (10), pp. e3239. Date of Electronic Publication: 2014 Oct 23 (Print Publication: 2014).
DOI: 10.1371/journal.pntd.0003239
Abstrakt: Background: Malaria and dengue are the most prevalent vector-borne diseases worldwide and represent major public health problems. Both are endemic in tropical regions, propitiating co-infection. Only few co-infection cases have been reported around the world, with insufficient data so far to enhance the understanding of the effects of co-infection in the clinical presentation and severity.
Methodology/principal Findings: A cross-sectional study was conducted (2009 to 2011) in hospitalized patients with acute febrile syndrome in the Brazilian Amazon. All patients were submitted to thick blood smear and PCR for Plasmodium sp. detection, ELISA, PCR and NS1 tests for dengue, viral hepatitis, HIV and leptospirosis. In total, 1,578 patients were recruited. Among them, 176 (11.1%) presented P. vivax malaria mono-infection, 584 (37%) dengue fever mono-infection, and 44 (2.8%) were co-infected. Co-infected patients had a higher chance of presenting severe disease (vs. dengue mono-infected), deep bleeding (vs. P. vivax mono-infected), hepatomegaly, and jaundice (vs. dengue mono-infected).
Conclusions/significance: In endemic areas for dengue and malaria, jaundice (in dengue patients) and spontaneous bleeding (in malaria patients) should raise the suspicion of co-infection. Besides, whenever co-infection is confirmed, we recommend careful monitoring for bleeding and hepatic complications, which may result in a higher chance of severity, despite of the fact that no increased fatality rate was seen in this group.
Databáze: MEDLINE
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