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Severe morbidity and mortality risk from malaria in the United States, 1985-2011.
Open Forum Infect Dis. 2014 Mar; 1(1):ofu034.OF

Abstract

BACKGROUND

Recent reports of Plasmodium vivax associated with severe syndromes and mortality from malaria endemic areas questions the "benign" course of non-falciparum malarias.

METHODS

We retrospectively analyzed data from patients reported to the US Centers for Disease Control and Prevention with a diagnosis of malaria parasite single-species infection between 1985 and 2011. Patients classified as having severe illness were further classified according to outcome (survival versus death) and clinical syndrome.

RESULTS

Among all cases, .9% of Plasmodium falciparum cases resulted in death and 9.3% were classified as severe, whereas .09% of P. vivax cases resulted in death and 1.3% were classified as severe. The odds ratios for severe illness among 15 272 diagnoses of P. falciparum relative to patients diagnosed with P. vivax (n = 12 152), Plasmodium malariae (n = 1254), or Plasmodium ovale (n = 903) was 7.5, 5.7, and 5.0, respectively (P < .0001 for all); in contrast, the corresponding odds ratios for death among those severely ill was 1.6, 1.1, and .8 (P > .1 for all), respectively. Compared with P. vivax (n = 163), the odds of P. falciparum cases classified as severely ill (n = 1416) were 1.9 (P = .0006), .5 (P = .001), and 1.3 times (P = .1) as likely to present as cerebral, acute respiratory distress, and renal syndromes, respectively.

CONCLUSIONS

Although less common, patients presenting with non-falciparum even in the United States can develop severe illness, and severe illness in patients having malaria of any species threatens life.

Authors+Show Affiliations

Malaria Branch , Centers for Disease Control and Prevention , Atlanta , Georgia ; Global Health Group , University of California , San Francisco , California.Malaria Branch , Centers for Disease Control and Prevention , Atlanta , Georgia.Malaria Branch , Centers for Disease Control and Prevention , Atlanta , Georgia.Malaria Branch , Centers for Disease Control and Prevention , Atlanta , Georgia.Eijkman-Oxford Clinical Research Unit , Jakarta , Indonesia ; Centre for Tropical Medicine, Nuffield Department of Medicine , University of Oxford , United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25734104

Citation

Hwang, Jimee, et al. "Severe Morbidity and Mortality Risk From Malaria in the United States, 1985-2011." Open Forum Infectious Diseases, vol. 1, no. 1, 2014, pp. ofu034.
Hwang J, Cullen KA, Kachur SP, et al. Severe morbidity and mortality risk from malaria in the United States, 1985-2011. Open forum infectious diseases. 2014;1(1):ofu034.
Hwang, J., Cullen, K. A., Kachur, S. P., Arguin, P. M., & Baird, J. K. (2014). Severe morbidity and mortality risk from malaria in the United States, 1985-2011. Open Forum Infectious Diseases, 1(1), ofu034. https://doi.org/10.1093/ofid/ofu034
Hwang J, et al. Severe Morbidity and Mortality Risk From Malaria in the United States, 1985-2011. Open forum infectious diseases. 2014;1(1):ofu034. PubMed PMID: 25734104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severe morbidity and mortality risk from malaria in the United States, 1985-2011. AU - Hwang,Jimee, AU - Cullen,Karen A, AU - Kachur,S Patrick, AU - Arguin,Paul M, AU - Baird,J Kevin, Y1 - 2014/06/30/ PY - 2014/04/23/received PY - 2014/05/15/accepted PY - 2015/3/4/entrez PY - 2015/3/4/pubmed PY - 2015/3/4/medline KW - Plasmodium KW - USA KW - morbidity KW - mortality KW - species SP - ofu034 EP - ofu034 JF - Open forum infectious diseases VL - 1 IS - 1 N2 - BACKGROUND: Recent reports of Plasmodium vivax associated with severe syndromes and mortality from malaria endemic areas questions the "benign" course of non-falciparum malarias. METHODS: We retrospectively analyzed data from patients reported to the US Centers for Disease Control and Prevention with a diagnosis of malaria parasite single-species infection between 1985 and 2011. Patients classified as having severe illness were further classified according to outcome (survival versus death) and clinical syndrome. RESULTS: Among all cases, .9% of Plasmodium falciparum cases resulted in death and 9.3% were classified as severe, whereas .09% of P. vivax cases resulted in death and 1.3% were classified as severe. The odds ratios for severe illness among 15 272 diagnoses of P. falciparum relative to patients diagnosed with P. vivax (n = 12 152), Plasmodium malariae (n = 1254), or Plasmodium ovale (n = 903) was 7.5, 5.7, and 5.0, respectively (P < .0001 for all); in contrast, the corresponding odds ratios for death among those severely ill was 1.6, 1.1, and .8 (P > .1 for all), respectively. Compared with P. vivax (n = 163), the odds of P. falciparum cases classified as severely ill (n = 1416) were 1.9 (P = .0006), .5 (P = .001), and 1.3 times (P = .1) as likely to present as cerebral, acute respiratory distress, and renal syndromes, respectively. CONCLUSIONS: Although less common, patients presenting with non-falciparum even in the United States can develop severe illness, and severe illness in patients having malaria of any species threatens life. SN - 2328-8957 UR - https://www.unboundmedicine.com/medline/citation/25734104/full_citation L2 - https://academic.oup.com/ofid/article-lookup/doi/10.1093/ofid/ofu034 DB - PRIME DP - Unbound Medicine ER -
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