Vivax malaria

a major cause of morbidity in early infancy

Jeanne Poespoprodjo, W FOBIA, Enny Kenangalem, D LAMPAH, A HASANUDDIN, N WARIKAR, P SUGIARTO, E TJITRA, Nicholas Anstey, Ric Price

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background. In areas where malaria is endemic, infants aged <3 months appear to be relatively protected from symptomatic and severe Plasmodium falciparum malaria, but less is known about the effect of Plasmodium vivax infection in this age group. Methods. To define malaria morbidity in the first year of life in an area where both multidrug-resistant P. falciparum and P. vivax are highly prevalent, data were gathered on all infants attending a referral hospital in Papua, Indonesia, using systematic data forms and hospital computerized records. Additional clinical and laboratory data were prospectively collected from inpatients aged <3 months. Results. From April 2004 through April 2008, 4976 infants were admitted to the hospital, of whom 1560 (31%) had malaria, with infection equally attributable to P. falciparum and P. vivax. The case-fatality rate was similar for inpatients with P. falciparum malaria (13 [2.2%] of 599 inpatients died) and P. vivax malaria (6 [1.0%] of 603 died; P = .161), whereas severe malarial anemia was more prevalent among those with P. vivax malaria (193 [32%] of 605 vs. 144 [24%] of 601; P = .025). Of the 187 infants aged <3 months, 102 (56%) had P. vivax malaria, and 55 (30%) had P. falciparum malaria. In these young infants, infection with P. vivax was associated with a greater risk of severe anemia (odds ratio, 2.4; 95% confidence interval, 1.03-5.91; P = .041) and severe thrombocytopenia (odds ratio, 3.3; 95% confidence interval, 1.07-10.6; P = .036) compared with those who have P. falciparum infection. Conclusions. P. vivax malaria is a major cause of morbidity in early infancy. Preventive strategies, early diagnosis, and prompt treatment should be initiated in the perinatal period. � 2009 by the Infectious Diseases Society of America. All rights reserved.
    Original languageEnglish
    Pages (from-to)1704-1712
    Number of pages9
    JournalClinical Infectious Diseases
    Volume48
    Issue number12
    Publication statusPublished - 2009

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    Vivax Malaria
    Plasmodium vivax
    Malaria
    Falciparum Malaria
    Morbidity
    Plasmodium falciparum
    Inpatients
    Anemia
    Odds Ratio
    Confidence Intervals
    Indonesia
    Hospital Records
    Infection
    Thrombocytopenia
    Early Diagnosis
    Referral and Consultation
    Age Groups
    Mortality

    Cite this

    Poespoprodjo, J., FOBIA, W., Kenangalem, E., LAMPAH, D., HASANUDDIN, A., WARIKAR, N., ... Price, R. (2009). Vivax malaria: a major cause of morbidity in early infancy. Clinical Infectious Diseases, 48(12), 1704-1712.
    Poespoprodjo, Jeanne ; FOBIA, W ; Kenangalem, Enny ; LAMPAH, D ; HASANUDDIN, A ; WARIKAR, N ; SUGIARTO, P ; TJITRA, E ; Anstey, Nicholas ; Price, Ric. / Vivax malaria : a major cause of morbidity in early infancy. In: Clinical Infectious Diseases. 2009 ; Vol. 48, No. 12. pp. 1704-1712.
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    abstract = "Background. In areas where malaria is endemic, infants aged <3 months appear to be relatively protected from symptomatic and severe Plasmodium falciparum malaria, but less is known about the effect of Plasmodium vivax infection in this age group. Methods. To define malaria morbidity in the first year of life in an area where both multidrug-resistant P. falciparum and P. vivax are highly prevalent, data were gathered on all infants attending a referral hospital in Papua, Indonesia, using systematic data forms and hospital computerized records. Additional clinical and laboratory data were prospectively collected from inpatients aged <3 months. Results. From April 2004 through April 2008, 4976 infants were admitted to the hospital, of whom 1560 (31{\%}) had malaria, with infection equally attributable to P. falciparum and P. vivax. The case-fatality rate was similar for inpatients with P. falciparum malaria (13 [2.2{\%}] of 599 inpatients died) and P. vivax malaria (6 [1.0{\%}] of 603 died; P = .161), whereas severe malarial anemia was more prevalent among those with P. vivax malaria (193 [32{\%}] of 605 vs. 144 [24{\%}] of 601; P = .025). Of the 187 infants aged <3 months, 102 (56{\%}) had P. vivax malaria, and 55 (30{\%}) had P. falciparum malaria. In these young infants, infection with P. vivax was associated with a greater risk of severe anemia (odds ratio, 2.4; 95{\%} confidence interval, 1.03-5.91; P = .041) and severe thrombocytopenia (odds ratio, 3.3; 95{\%} confidence interval, 1.07-10.6; P = .036) compared with those who have P. falciparum infection. Conclusions. P. vivax malaria is a major cause of morbidity in early infancy. Preventive strategies, early diagnosis, and prompt treatment should be initiated in the perinatal period. � 2009 by the Infectious Diseases Society of America. All rights reserved.",
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    author = "Jeanne Poespoprodjo and W FOBIA and Enny Kenangalem and D LAMPAH and A HASANUDDIN and N WARIKAR and P SUGIARTO and E TJITRA and Nicholas Anstey and Ric Price",
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    Poespoprodjo, J, FOBIA, W, Kenangalem, E, LAMPAH, D, HASANUDDIN, A, WARIKAR, N, SUGIARTO, P, TJITRA, E, Anstey, N & Price, R 2009, 'Vivax malaria: a major cause of morbidity in early infancy', Clinical Infectious Diseases, vol. 48, no. 12, pp. 1704-1712.

    Vivax malaria : a major cause of morbidity in early infancy. / Poespoprodjo, Jeanne; FOBIA, W; Kenangalem, Enny; LAMPAH, D; HASANUDDIN, A; WARIKAR, N; SUGIARTO, P; TJITRA, E; Anstey, Nicholas; Price, Ric.

    In: Clinical Infectious Diseases, Vol. 48, No. 12, 2009, p. 1704-1712.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Vivax malaria

    T2 - a major cause of morbidity in early infancy

    AU - Poespoprodjo, Jeanne

    AU - FOBIA, W

    AU - Kenangalem, Enny

    AU - LAMPAH, D

    AU - HASANUDDIN, A

    AU - WARIKAR, N

    AU - SUGIARTO, P

    AU - TJITRA, E

    AU - Anstey, Nicholas

    AU - Price, Ric

    PY - 2009

    Y1 - 2009

    N2 - Background. In areas where malaria is endemic, infants aged <3 months appear to be relatively protected from symptomatic and severe Plasmodium falciparum malaria, but less is known about the effect of Plasmodium vivax infection in this age group. Methods. To define malaria morbidity in the first year of life in an area where both multidrug-resistant P. falciparum and P. vivax are highly prevalent, data were gathered on all infants attending a referral hospital in Papua, Indonesia, using systematic data forms and hospital computerized records. Additional clinical and laboratory data were prospectively collected from inpatients aged <3 months. Results. From April 2004 through April 2008, 4976 infants were admitted to the hospital, of whom 1560 (31%) had malaria, with infection equally attributable to P. falciparum and P. vivax. The case-fatality rate was similar for inpatients with P. falciparum malaria (13 [2.2%] of 599 inpatients died) and P. vivax malaria (6 [1.0%] of 603 died; P = .161), whereas severe malarial anemia was more prevalent among those with P. vivax malaria (193 [32%] of 605 vs. 144 [24%] of 601; P = .025). Of the 187 infants aged <3 months, 102 (56%) had P. vivax malaria, and 55 (30%) had P. falciparum malaria. In these young infants, infection with P. vivax was associated with a greater risk of severe anemia (odds ratio, 2.4; 95% confidence interval, 1.03-5.91; P = .041) and severe thrombocytopenia (odds ratio, 3.3; 95% confidence interval, 1.07-10.6; P = .036) compared with those who have P. falciparum infection. Conclusions. P. vivax malaria is a major cause of morbidity in early infancy. Preventive strategies, early diagnosis, and prompt treatment should be initiated in the perinatal period. � 2009 by the Infectious Diseases Society of America. All rights reserved.

    AB - Background. In areas where malaria is endemic, infants aged <3 months appear to be relatively protected from symptomatic and severe Plasmodium falciparum malaria, but less is known about the effect of Plasmodium vivax infection in this age group. Methods. To define malaria morbidity in the first year of life in an area where both multidrug-resistant P. falciparum and P. vivax are highly prevalent, data were gathered on all infants attending a referral hospital in Papua, Indonesia, using systematic data forms and hospital computerized records. Additional clinical and laboratory data were prospectively collected from inpatients aged <3 months. Results. From April 2004 through April 2008, 4976 infants were admitted to the hospital, of whom 1560 (31%) had malaria, with infection equally attributable to P. falciparum and P. vivax. The case-fatality rate was similar for inpatients with P. falciparum malaria (13 [2.2%] of 599 inpatients died) and P. vivax malaria (6 [1.0%] of 603 died; P = .161), whereas severe malarial anemia was more prevalent among those with P. vivax malaria (193 [32%] of 605 vs. 144 [24%] of 601; P = .025). Of the 187 infants aged <3 months, 102 (56%) had P. vivax malaria, and 55 (30%) had P. falciparum malaria. In these young infants, infection with P. vivax was associated with a greater risk of severe anemia (odds ratio, 2.4; 95% confidence interval, 1.03-5.91; P = .041) and severe thrombocytopenia (odds ratio, 3.3; 95% confidence interval, 1.07-10.6; P = .036) compared with those who have P. falciparum infection. Conclusions. P. vivax malaria is a major cause of morbidity in early infancy. Preventive strategies, early diagnosis, and prompt treatment should be initiated in the perinatal period. � 2009 by the Infectious Diseases Society of America. All rights reserved.

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    Poespoprodjo J, FOBIA W, Kenangalem E, LAMPAH D, HASANUDDIN A, WARIKAR N et al. Vivax malaria: a major cause of morbidity in early infancy. Clinical Infectious Diseases. 2009;48(12):1704-1712.