Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.

Vivax malaria was historically described as 'benign tertian malaria' because individual clinical episodes were less likely to cause severe illness than Plasmodium falciparum. Despite this, Plasmodium vivax was, and remains, responsible for major morbidity and significant mortality in vivax...

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Main Authors: Anstey, N, Douglas, N, Poespoprodjo, JR, Price, R
Format: Journal article
Language:English
Published: 2012
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author Anstey, N
Douglas, N
Poespoprodjo, JR
Price, R
author_facet Anstey, N
Douglas, N
Poespoprodjo, JR
Price, R
author_sort Anstey, N
collection OXFORD
description Vivax malaria was historically described as 'benign tertian malaria' because individual clinical episodes were less likely to cause severe illness than Plasmodium falciparum. Despite this, Plasmodium vivax was, and remains, responsible for major morbidity and significant mortality in vivax-endemic areas. Single infections causing febrile illness in otherwise healthy individuals rarely progress to severe disease. Nevertheless, in the presence of co-morbidities, P. vivax can cause severe illness and fatal outcomes. Recurrent or chronic infections in endemic areas can cause severe anaemia and malnutrition, particularly in early childhood. Other severe manifestations include acute lung injury, acute kidney injury and uncommonly, coma. Multiorgan failure and shock are described but further studies are needed to investigate the role of bacterial and other co-infections in these syndromes. In pregnancy, P. vivax infection can cause maternal anaemia, miscarriage, low birth weight and congenital malaria. Compared to P. falciparum, P. vivax has a greater capacity to elicit an inflammatory response, resulting in a lower pyrogenic threshold. Conversely, cytoadherence of P. vivax to endothelial cells is less frequent and parasite sequestration is not thought to be a significant cause of severe illness in vivax malaria. With a predilection for young red cells, P. vivax does not result in the high parasite biomass associated with severe disease in P. falciparum, but a four to fivefold greater removal of uninfected red cells from the circulation relative to P. falciparum is associated with a similar risk of severe anaemia. Mechanisms underlying the pathogenesis of severe vivax syndromes remain incompletely understood.
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spelling oxford-uuid:1b6e1564-495f-468c-beea-2b0d16fa821a2022-03-26T11:00:20ZPlasmodium vivax: clinical spectrum, risk factors and pathogenesis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1b6e1564-495f-468c-beea-2b0d16fa821aEnglishSymplectic Elements at Oxford2012Anstey, NDouglas, NPoespoprodjo, JRPrice, RVivax malaria was historically described as 'benign tertian malaria' because individual clinical episodes were less likely to cause severe illness than Plasmodium falciparum. Despite this, Plasmodium vivax was, and remains, responsible for major morbidity and significant mortality in vivax-endemic areas. Single infections causing febrile illness in otherwise healthy individuals rarely progress to severe disease. Nevertheless, in the presence of co-morbidities, P. vivax can cause severe illness and fatal outcomes. Recurrent or chronic infections in endemic areas can cause severe anaemia and malnutrition, particularly in early childhood. Other severe manifestations include acute lung injury, acute kidney injury and uncommonly, coma. Multiorgan failure and shock are described but further studies are needed to investigate the role of bacterial and other co-infections in these syndromes. In pregnancy, P. vivax infection can cause maternal anaemia, miscarriage, low birth weight and congenital malaria. Compared to P. falciparum, P. vivax has a greater capacity to elicit an inflammatory response, resulting in a lower pyrogenic threshold. Conversely, cytoadherence of P. vivax to endothelial cells is less frequent and parasite sequestration is not thought to be a significant cause of severe illness in vivax malaria. With a predilection for young red cells, P. vivax does not result in the high parasite biomass associated with severe disease in P. falciparum, but a four to fivefold greater removal of uninfected red cells from the circulation relative to P. falciparum is associated with a similar risk of severe anaemia. Mechanisms underlying the pathogenesis of severe vivax syndromes remain incompletely understood.
spellingShingle Anstey, N
Douglas, N
Poespoprodjo, JR
Price, R
Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.
title Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.
title_full Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.
title_fullStr Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.
title_full_unstemmed Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.
title_short Plasmodium vivax: clinical spectrum, risk factors and pathogenesis.
title_sort plasmodium vivax clinical spectrum risk factors and pathogenesis
work_keys_str_mv AT ansteyn plasmodiumvivaxclinicalspectrumriskfactorsandpathogenesis
AT douglasn plasmodiumvivaxclinicalspectrumriskfactorsandpathogenesis
AT poespoprodjojr plasmodiumvivaxclinicalspectrumriskfactorsandpathogenesis
AT pricer plasmodiumvivaxclinicalspectrumriskfactorsandpathogenesis