Volume 93, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Severe malaria is uncommon in South America. Lima, Peru, while not endemic for malaria, is home to specialized centers for infectious diseases that admit and manage patients with severe malaria (SM), all of whom contracted infection during travel. This retrospective study describes severe travel-related malaria in individuals admitted to one tertiary care referral hospital in Lima, Peru; severity was classified based on criteria published by the World Health Organization in 2000. Data were abstracted from medical records of patients with SM admitted to Hospital Nacional Cayetano Heredia from 2006 to 2011. Of 33 SM cases with complete clinical data, the mean age was 39 years and the male/female ratio was 2.8. Most cases were contracted in known endemic regions within Peru: Amazonia (47%), the central jungle (18%), and the northern coast (12%); cases were also found in five (15%) travelers returning from Africa. was most commonly identified (71%) among the severe infections, followed by (18%); mixed infections composed 11% of the group. Among the criteria of severity, jaundice was most common (58%), followed by severe thrombocytopenia (47%), hyperpyrexia (32%), and shock (15%). mono-infection predominated as the etiology of SM in cases acquired in Peru.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. World Health Organization, 2013. World Malaria Report 2013. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/malaria/publications/world_malaria_report_2013/en/. Accessed May 31, 2015. [Google Scholar]
  2. Sabbag A, Schwartz E, , 2010. The awareness of malaria in primary care medicine. Harefuah 149: 568571. [Google Scholar]
  3. Siqueira AM, Lacerda MV, Magalhaes BM, Mourao MP, Melo GC, Alexandre MA, Alecrim MG, Kochar D, Kochar S, Kochar A, Nayak K, Del Portillo H, Guinovart C, Alonso P, Bassat Q, , 2015. Characterization of Plasmodium vivax-associated admissions to reference hospitals in Brazil and India. BMC Med 13: 5771.[Crossref] [Google Scholar]
  4. World Health Organization, 2014. Severe malaria. Trop Med Int Health 19 (Suppl 1): 7131. [Google Scholar]
  5. World Health Organization, 1990. Severe and complicated malaria. World Health Organization, Division of Control of Tropical Diseases. Trans R Soc Trop Med Hyg 84 (Suppl 2): 165. [Google Scholar]
  6. World Health Organization, 2000. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg 94 (Suppl 1): S1S90. [Google Scholar]
  7. World Health Organization, 2010. Guidelines for the Treatment of Malaria, 2nd edition. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/malaria/publications/atoz/9789241547925/en/. Accessed September 28, 2015. [Google Scholar]
  8. Picot S, , 2006. Is Plasmodium vivax still a paradigm for uncomplicated malaria? Med Mal Infect 36: 406413.[Crossref] [Google Scholar]
  9. Beg MA, Khan R, Baig SM, Gulzar Z, Hussain R, Smego RA, Jr, 2002. Cerebral involvement in benign tertian malaria. Am J Trop Med Hyg 67: 230232. [Google Scholar]
  10. Koh KH, Chew PH, Kiyu A, , 2005. A retrospective study of malaria infections in an intensive care unit of a general hospital in Malaysia. Singapore Med J 45: 2836. [Google Scholar]
  11. Kochar DK, Saxena V, Singh N, Kochar SK, Kumar SV, Das A, , 2005. Plasmodium vivax malaria. Emerg Infect Dis 11: 132134.[Crossref] [Google Scholar]
  12. Price RN, Douglas NM, Anstey NM, , 2009. New developments in Plasmodium vivax malaria: severe disease and the rise of chloroquine resistance. Curr Opin Infect Dis 22: 430435.[Crossref] [Google Scholar]
  13. Ministerio de Salud del Peru, Direccion General de Epidemiologia, 2010. Analisis de la Situacion de Salud del Peru. Available at: http://www.dge.gob.pe/publicaciones/pub_asis/asis25.pdf. Accessed March 21, 2014. [Google Scholar]
  14. Ministerio de Salud del Peru, 2013. Tendencia y situación de las enfermedades sujetas a vigilancia epidemiológica: malaria. Bol Epidemiol 22: 10881097. [Google Scholar]
  15. Ministerio de Salud del Peru, 2007. Norma Tecnica de Salud para la Atencion de la Malaria y Malaria Grave en el Peru. Available at: http://www.minsa.gob.pe/portada/esnemo_normatividad.asp#. Accessed January 27, 2012. [Google Scholar]
  16. Warrell DA, Cox TM, Firth JD, Benz EJ, Jr (eds.), 2003. Oxford Textbook of Medicine, 4th edition. Oxford, United Kingdom: Oxford University Press. [Google Scholar]
  17. Chuquiyauri R, Paredes M, Peñataro P, Torres S, Marin S, Tenorio A, Brouwer KC, Abeles S, Llanos-Cuentas A, Gilman RH, Kosek M, Vinetz JM, , 2012. Socio-demographics and the development of malaria elimination strategies in the low transmission setting. Acta Trop 121: 292302.[Crossref] [Google Scholar]
  18. Ministerio de Salud del Peru, 2001. Factores de Riesgo de la Malaria Grave en el Peru. Available at: http://bvs.minsa.gob.pe/local/minsa/1772.pdf. Accessed March 15, 2012. [Google Scholar]
  19. Mueller I, Galinski MR, Baird JK, Carlton JM, Kochar DK, Alonso PL, del Portillo HA, , 2009. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis 9: 555566.[Crossref] [Google Scholar]
  20. Singh H, Parakh A, Basu S, Rath B, , 2011. Plasmodium vivax malaria: is it actually benign? J Infect Public Health 4: 9195.[Crossref] [Google Scholar]
  21. Steenkeste N, Incardona S, Chy S, Duval L, Ekala M, Lim P, Hewitt S, Sochantha T, Socheat D, Rogier C, Mercereau-Puijalon O, Fandeur T, Ariey F, , 2009. Towards high-throughput molecular detection of Plasmodium: new approaches and molecular markers. Malar J 8: 8697.[Crossref] [Google Scholar]
  22. Srivastava S, Ahmad S, Shirazi N, Kumar Verma S, Puri P, , 2011. Retrospective analysis of vivax malaria patients presenting to tertiary referral centre of Uttarakhand. Acta Trop 117: 8285.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 18 Oct 2014
  • Accepted : 01 Sep 2015
  • Published online : 09 Dec 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error