Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports

Abstract Background Plasmodium vivax rarely develops severe complications when compared to severe falciparum malaria. However, severe vivax malaria also needs urgent, intensive care and treatment as severe falciparum malaria. This systematic review aimed to explore pooled prevalence of severe vivax...

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Main Authors: Manas Kotepui, Kwuntida Uthaisar Kotepui, Giovanni De Jesus Milanez, Frederick Ramirez Masangkay
Format: Article
Language:English
Published: BMC 2020-05-01
Series:BMC Infectious Diseases
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12879-020-05046-y
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author Manas Kotepui
Kwuntida Uthaisar Kotepui
Giovanni De Jesus Milanez
Frederick Ramirez Masangkay
author_facet Manas Kotepui
Kwuntida Uthaisar Kotepui
Giovanni De Jesus Milanez
Frederick Ramirez Masangkay
author_sort Manas Kotepui
collection DOAJ
description Abstract Background Plasmodium vivax rarely develops severe complications when compared to severe falciparum malaria. However, severe vivax malaria also needs urgent, intensive care and treatment as severe falciparum malaria. This systematic review aimed to explore pooled prevalence of severe vivax malaria and to identify factors related to poor outcome of patients who developed severe manifestation. Methods The systematic review conducted by two reviewers independently through searching of research publications related to severe P. vivax malaria in three databases including MEDLINE, Web of Science (ISI), and Scopus until October, 22 2019. The pooled prevalence of severe vivax malaria was achieved using STATA and RevMan 5 Software. Factors related to poor outcome of patients with severe vivax malaria were analyzed using SPSS 11.5 Software. Results Among 2615 research publications retrieved from three databases, 49 articles reporting on 42,325 severity cases were selected for calculating pooled prevalence. Seventy-six patients from case reports, case series, letter to editors, and research communications were collected to identify factors related to poor outcome of patients with severe vivax malaria. The results showed that severe anemia, jaundice, respiratory distress, impaired consciousness, and renal failure were the most common major manifestations of severe malaria guided by the World Health Organization (WHO) criterion. The meta-analysis indicated that severe malaria was less frequent in patient with P. vivax compared to those with P. falciparum (P -value < 0.00001, OR = 0.38, 95% CI = 0.25–0.56, I2 = 87%). In addition, thrombocytopenia, anemia, hepatitis, and severe thrombocytopenia were the most common minor complications. Analysis of cases indicated that convulsion, respiratory distress, renal failure, jaundice, anuria/oliguria, and complication during treatment impacted on longer hospital stays compared to other severe complications (P-value < 0.05). Respiratory distress was frequently found after first treatment with anti-malarial drugs (P-value = 0.002). Renal failure was frequently found before treatment with anti-malarial drugs (P-value = 0.016). Mean days of fever and higher pulse rates at presentation were predictors of poor outcome among patients with severe vivax malaria (P-value < 0.05). Conclusions Severe anemia was the most common major manifestation of P. vivax malaria guided by the WHO criterion. Severe anemia was found less frequently in patients with P. vivax than those with P. falciparum. Renal failure, jaundice, anuria/oliguria, and complication during treatment along with, mean days of fever and higher pulse rates at presentation might be predictors of poor outcome of patients with severe vivax malaria.
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spelling doaj.art-9d4d36bd70ca4ddaba00c66317d462172022-12-21T23:01:51ZengBMCBMC Infectious Diseases1471-23342020-05-0120111410.1186/s12879-020-05046-yPrevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reportsManas Kotepui0Kwuntida Uthaisar Kotepui1Giovanni De Jesus Milanez2Frederick Ramirez Masangkay3Medical Technology, School of Allied Health Sciences, Walailak UniversityMedical Technology, School of Allied Health Sciences, Walailak UniversityDepartment of Medical Technology, Far Eastern UniversityDepartment of Medical Technology, Far Eastern UniversityAbstract Background Plasmodium vivax rarely develops severe complications when compared to severe falciparum malaria. However, severe vivax malaria also needs urgent, intensive care and treatment as severe falciparum malaria. This systematic review aimed to explore pooled prevalence of severe vivax malaria and to identify factors related to poor outcome of patients who developed severe manifestation. Methods The systematic review conducted by two reviewers independently through searching of research publications related to severe P. vivax malaria in three databases including MEDLINE, Web of Science (ISI), and Scopus until October, 22 2019. The pooled prevalence of severe vivax malaria was achieved using STATA and RevMan 5 Software. Factors related to poor outcome of patients with severe vivax malaria were analyzed using SPSS 11.5 Software. Results Among 2615 research publications retrieved from three databases, 49 articles reporting on 42,325 severity cases were selected for calculating pooled prevalence. Seventy-six patients from case reports, case series, letter to editors, and research communications were collected to identify factors related to poor outcome of patients with severe vivax malaria. The results showed that severe anemia, jaundice, respiratory distress, impaired consciousness, and renal failure were the most common major manifestations of severe malaria guided by the World Health Organization (WHO) criterion. The meta-analysis indicated that severe malaria was less frequent in patient with P. vivax compared to those with P. falciparum (P -value < 0.00001, OR = 0.38, 95% CI = 0.25–0.56, I2 = 87%). In addition, thrombocytopenia, anemia, hepatitis, and severe thrombocytopenia were the most common minor complications. Analysis of cases indicated that convulsion, respiratory distress, renal failure, jaundice, anuria/oliguria, and complication during treatment impacted on longer hospital stays compared to other severe complications (P-value < 0.05). Respiratory distress was frequently found after first treatment with anti-malarial drugs (P-value = 0.002). Renal failure was frequently found before treatment with anti-malarial drugs (P-value = 0.016). Mean days of fever and higher pulse rates at presentation were predictors of poor outcome among patients with severe vivax malaria (P-value < 0.05). Conclusions Severe anemia was the most common major manifestation of P. vivax malaria guided by the WHO criterion. Severe anemia was found less frequently in patients with P. vivax than those with P. falciparum. Renal failure, jaundice, anuria/oliguria, and complication during treatment along with, mean days of fever and higher pulse rates at presentation might be predictors of poor outcome of patients with severe vivax malaria.http://link.springer.com/article/10.1186/s12879-020-05046-yP. vivaxDischargeTreatment outcomeSevere malariaPoor outcome
spellingShingle Manas Kotepui
Kwuntida Uthaisar Kotepui
Giovanni De Jesus Milanez
Frederick Ramirez Masangkay
Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports
BMC Infectious Diseases
P. vivax
Discharge
Treatment outcome
Severe malaria
Poor outcome
title Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports
title_full Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports
title_fullStr Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports
title_full_unstemmed Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports
title_short Prevalence and risk factors related to poor outcome of patients with severe Plasmodium vivax infection: a systematic review, meta-analysis, and analysis of case reports
title_sort prevalence and risk factors related to poor outcome of patients with severe plasmodium vivax infection a systematic review meta analysis and analysis of case reports
topic P. vivax
Discharge
Treatment outcome
Severe malaria
Poor outcome
url http://link.springer.com/article/10.1186/s12879-020-05046-y
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