Evaluation of Plasma Lactate as a Parameter for Disease Severity on Admission in Travelers with Plasmodium falciparum Malaria (original) (raw)
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Clinical Intensive Care, 2006
Objective. To study the prognostic significance of plasma lactate levels as a functional marker for tissue hypoxia on admission in non-immune travellers with imported Plasmodium falciparum malaria and non-P. falciparum malaria. Design. Crosssectional, prospective, observational study. Setting. Harbour Hospital, Institute for Tropical Diseases, a national referral centre for tropical diseases. Patients. One hundred and twenty-two non-immune travellers with imported malaria (one patient with P. malariae, four with P. ovale, 20 with P. vivax, 83 with uncomplicated P. falciparum and 14 patients with severe, complicated P. falciparum infection). Measurements. Plasma lactate levels and standard laboratory evaluations on admission in relation to malaria species and criteria for severe malaria. Results. The plasma lactate levels on admission of those travellers who acquired a severe P. falciparum infection were higher than those with either uncomplicated P. falciparum malaria or travellers with non-P. falciparum infections. In the group of travellers with P. falciparum infection, an increased plasma lactate level 2.2 mmol/l had a sensitivity of 64%, a specificity of 89%, a positive predictive value of 50% and a negative predictive value of 94% for severe disease. Conclusions. A timely determination of plasma lactate on admission may assist in the clinical decision making of travellers with malaria who should be candidates for intensified monitoring and parenteral treatment.
Biology, 2021
Metabolic acidosis in severe malaria usually occurs in the form of lactic acidosis. The present study aimed to collate articles from the literature that have reported blood lactate levels in patients with severe malaria and tested the hypothesis that blood lactate levels are elevated in patients with malaria compared to those with uncomplicated malaria. Moreover, the difference in lactate levels between patients who died and those who survived was estimated using a meta-analytic approach. Potentially relevant studies were searched for in PubMed, Web of Science, and Scopus. The quality of the included studies was assessed using the Jadad scale and strengthening the reporting of observational studies in epidemiology (STROBE). The pooled mean blood lactate in patients with severe malaria, the pooled weighted mean difference (WMD) of blood lactate between patients with severe malaria and those with uncomplicated malaria, and the pooled WMD and 95% CI of blood lactate between patients wh...
IOSR Journal of Pharmacy and Biological Sciences, 2012
Background : Lactate dehydrogenase (LDH) activity was assayed in the sera of 40 adult male and 40 adult female patients within the age group of 16-50 years presenting with acute, Plasmodium falciparum malaria infection and a control group of 40 healthy adults within the same age group. Study objective: Study was design to determine diagnostic value of serum LDH activity in patient with acute P.falciparum Infection. Methods: Patient selection and pre-qualification were done by simple random sampling of individuals presenting at the MBS Hospital Outpatient Department with a history of fever and malaise within a period of one to eight days, and who were confirmed to be infected with the P. falciparum malaria parasite by microscopically examination of Giemsa-stained thin blood slides. Results: The mean serum LDH activity in male patients was found to be 564 ±236.0 IU. This activity is significantly higher than the control LDH activity of 237.10±19.0 IU (p-value is less than 0.05). The mean serum LDH activity among female patients was 468 ±177.0 IU, which is a relatively higher activity compared to the control LDH activity of 237.10 ±19.0 IU (p-value is less than 0.05). Conclusion: The combination of acute hepatocellular injury and red cell haemolysis induced by the invading merozoites may account for the increase in serum LDH activity during this infection. Therefore serum LDH activity is a potentially valuable enzymatic marker of falciparum malaria infection.
Total serum lactate dehydrogenase activity in acute Plasmodium falciparum malaria infection
Singapore medical journal, 2005
Lactate dehydrogenase (LDH) activity was assayed in the sera of 76 adult male and 76 adult female patients within the age group of 18-40 years presenting with acute, uncomplicated Plasmodium falciparum malaria infection and a control group of 80 healthy adults within the same age group. Patient selection and pre-qualification were done by simple random sampling of individuals presenting at the Bauchi Specialist Hospital Outpatient Department with a history of fever and malaise within a period of one to eight days, and who were confirmed to be infected with the P. falciparum malaria parasite by microscopical examination of Giemsa-stained thin blood slides. The mean serum LDH activity in male patients was found to be 789.4 +/- 35.0 IU. This activity is significantly higher than the control LDH activity of 247.10 +/- 19.0 IU (p-value is less than 0.05). The mean serum LDH activity among female patients was 634.0 +/- 35.0 IU, which is a relatively higher activity compared to the control...
Malária por Plasmodium falciparum: estudos proteômicos
Revista Brasileira de Terapia Intensiva, 2012
Advances in treatment, prophylaxis, and control of malaria around the world have been substantial, yet they have not been sufficient to change the current outlook for the disease significantly. In fact, malaria is still the parasitosis with the greatest impact on the planet, figuring as the fifth cause of death from infectious diseases worldwide. (1,2) There are different outcomes of the clinical evolution, and severe malaria is one of them. Severe malaria is usually caused by Plasmodium falciparum and is characterized by disturbances in multiple organs and systems, such as metabolic acidosis, involvement of the central nervous system, severe anemia, shock, disseminated intravascular coagulation, pulmonary dysfunction, liver disorder, hypoglycemia, and renal insufficiency. This clinical picture is pathophysiologically similar to bacterial sepsis, (3) which requires treatment in an intensive care unit (ICU) to avoid progression to death. (4) Transferring a patient with suspected severe malaria to the ICU allows the early detection and proper management of complications that might culminate in a fatal outcome. (5-7) Due to peculiarities in the clinical management of these complications, the integration between intensive care doctors and specialists in tropical medicine/ infectious diseases facilitates a more favorable outcome in affected patients. (6) Consequently, the intensive care doctor must know the epidemiological, clinical, diagnostic, and therapeutic concepts behind malaria, within the context of the so-called "intensive care for infection". (8)
Objectives: 1. The frequency of malaria (falciparum and vivax malaria) in febrile children reporting to pediatric unit at tertiary care hospital. 2. To evaluate the severity in children suffering from malaria Subject & Methods : Study was conducted in Pediatric Medicine Department of Liaquat University Hospital Hyderabad, total duration was 6 months from May to November 2011. Study was descriptive case series. 205 febrile patients were selected for the study aft er taken consent. Data were collected on a structured proforma. Detailed history, examination and investigations were done. Results: Within 205 patients a total of 112 (54.63%) were males and 93 (45.37%) were females. Malarial parasites were present in 19 (9.3%) out of 205 patients. Plasmodium falciparum was seen in 12 (63.1%) of cases, whereas P. vivax was noted to be present in 7 (36.8%) patients. Severe malaria was present in 8 (42.1%) patients. Fits were seen in 6 (31.57%), jaundice in 2 (10.5%), respi ratory distress were in 3 (15.7%), 5 patients (26.3%) were brought in an unconscious state to the hospital, hemoglobin <5 g/dl was seen in 19 (100%) patients and hypoglycemia (RBS <40 mg/dl) was seen in 3 (15.7%) patients out of 19 respectively. Chi square (or Fischer’s exact Test) were applied to see the relationship of severe malaria (the main outcome variable) with other variables of study such as age, gender, fits, jaundice, respiratory distress, unconsciousness, low hemoglobin and hypoglycemia respecti vely. P value of <0.005 was considered to be statistically significant. The presence of severe malaria correlated with the severe Anemia (p 0.000), fits and unconsciousness were significant findings. Conclusion: In this study it was noted that malaria pres ents with various varied clinical presentations, but severe anemia, fits and unconsciousness have statistically significant associations with severe malaria.
Malaria Journal, 2011
Background: Counts of malaria parasites in peripheral blood are important to assess severity of Plasmodium falciparum malaria. Thin and thick smears are routinely used for this purpose. Methods: In this study the Binax NOW ® Malaria Test, an easy-to-perform rapid diagnostic test, with Histidine Rich Protein-2 (HRP-2) and aldolase as diagnostic markers, was used for semi-quantitative assessment of parasitaemia of P. faciparum. Results: In 257 patients with imported P. falciparum malaria, reactivity of aldolase increased with higher parasitaemia. In all patients with a parasitaemia above 50,000 asexual parasites/μl (> 1%) co-reactivity of HRP-2 and aldolase was observed. Absence of aldolase reactivity in the presence of HRP-2 was a reliable predictive marker to exclude high (> 1%) parasitaemia in P. falciparum malaria. Conclusions: Assessment of HRP-2 and aldolase co-reactivity can be of help in clinical decision making in the acute care setting of returning travellers suspected of having malaria.
Assessment of Liver Enzymes in the Patients Infected with Plasmodium
2017
Malaria is a mosquito born disease caused by protozoa belonging to family Plasmodium. According to the WHO, involvement of liver in Plasmodium falciparum is not an uncommon feature and presence of jaundice (bilirubin ≥ 3 mg/dl) is one of the signs of malaria. Involvement of liver in malaria is a common feature and may manifest as jaundice, hepatomegaly & elevated liver enzymes like aspartate & alanine transferase. Detection of malaria positive cases and correlation of all malaria positive cases with Liver Function Test (LFT). The study was performed on 100 malaria positive patients. Collection of blood sample was done by venipuncture under aseptic conditions in the EDTA vial for the diagnosis of malaria and in the plain vial to perform liver function test. Malaria was diagnosed by the microscopy of PBS. The LFT was performed using auto analyzer and Erba diagnostic kit, according to manufacturer instructions. Out of 100 malaria positive patients total 70 (70%) patients were found hav...
Malaria journal, 2006
Hyperlactataemia is often associated with a poor outcome in severe malaria in African children. To unravel the complex pathophysiology of this condition the relationship between plasma lactate levels, parasite density, pro- and anti-inflammatory cytokines, and haemozoin-containing leucocytes was studied in children with severe falciparum malarial anaemia. Twenty-six children with a primary diagnosis of severe malarial anaemia with any asexual Plasmodium falciparum parasite density and Hb < 5 g/dL were studied and the association of plasma lactate levels and haemozoin-containing leucocytes, parasite density, pro- and anti-inflammatory cytokines was measured. The same associations were measured in non-severe malaria controls (N = 60). Parasite density was associated with lactate levels on admission (r = 0.56, P < 0.005). Moreover, haemozoin-containing neutrophils and IL-12 were strongly associated with plasma lactate levels, independently of parasite density (r = 0.60, P = 0.003...
Repeated blood lactate measurements during clinical care of children with cerebral malaria
Background Admission blood lactate has previously guided therapy and is a valid estimator of prognosis in children with cerebral malaria (CM). Since bolus intravenous fluid administration to children with febrile coma and signs of hypovolemia (including high blood lactate) may be harmful, the use of blood lactate to guide therapy has waned. Its utility as a prognostic biomarker, either at admission or during hospitalization, remains unclear. Methods We performed a retrospective cohort study of 1674 Malawian children with CM hospitalized from 2000–2018 who had blood lactate measurements every 6 hours for the first 24 hours. We evaluated the strength of association between admission lactate or values measured at any time point in the first 24 hours post-admission, and outcomes (death or neurologic disability in survivors). We assessed the optimal duration of lactate monitoring of children with CM. Results When lactate is analyzed as a continuous variable, children with CM who have hig...