ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Breman JG, 2001. The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg 64 :1–11.
-
2
2000. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg 94 (Suppl 1):S1–90.
-
3
Minakawa N, Sonye G, Mogi M, Githeko A, Yan G, 2002. The effects of climatic factors on the distribution and abundance of malaria vectors in Kenya. J Med Entomol 39 :833–841.
-
4
Lindblade KA, Walker ED, Onapa AW, Katungu J, Wilson ML, 1999. Highland malaria in Uganda: prospective analysis of an epidemic associated with El Nino. Trans R Soc Trop Med Hyg 93 :480–487.
-
5
John CC, Sumba PO, Ouma JH, Nahlen BL, King CL, Kazura JW, 2000. Cytokine responses to Plasmodium falciparum liver-stage antigen 1 vary in rainy and dry seasons in highland Kenya. Infect Immun 68 :5198–5204.
-
6
John CC, Ouma JH, Sumba PO, Hollingdale MR, Kazura JW, King CL, 2002. Lymphocyte proliferation and antibody responses to Plasmodium falciparum liver-stage antigen-1 in a highland area of Kenya with seasonal variation in malaria transmission. Am J Trop Med Hyg 66 :372–378.
-
7
Hay SI, Noor AM, Simba M, Busolo M, Guyatt HL, Ochola SA, Snow RW, 2002. Clinical epidemiology of malaria in the highlands of western Kenya. Emerg Infect Dis 8 :543–548.
-
8
Ndyomugyenyi R, Magnussen P, 2001. Malaria morbidity, mortality and pregnancy outcome in areas with different levels of malaria transmission in Uganda: a hospital record-based study. Trans R Soc Trop Med Hyg 95 :463–468.
-
9
Lindblade KA, O’Neill DB, Mathanga DP, Katungu J, Wilson ML, 2000. Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health 5 :865–875.
-
10
Lindblade KA, Walker ED, Wilson ML, 2000. Early warning of malaria epidemics in African highlands using Anopheles (Diptera: Culicidae) indoor resting density. J Med Entomol 37 :664–674.
-
11
Shanks GD, Hay SI, Stern DI, Biomndo K, Snow RW, 2002. Meteorologic influences on Plasmodium falciparum malaria in the Highland Tea Estates of Kericho, Western Kenya. Emerg Infect Dis 8 :1404–1408.
-
12
Lindblade KA, Walker ED, Onapa AW, Katungu J, Wilson ML, 2000. Land use change alters malaria transmission parameters by modifying temperature in a highland area of Uganda. Trop Med Int Health 5 :263–274.
-
13
Cox J, Craig M, LeSueur D, Sharp B, 1999. Mapping malaria risk in the highlands of Africa. London, UK: MARA/HIMAL, 114.
-
14
Esamai F, Nabakwe E, Mining S, Forsberg P, Lewis DH, 1999. Clinical presentation and diagnosis of cerebral malaria in children in the highlands of western Kenya. East Afr Med J 76 :89–92.
-
15
Ndyomugyenyi R, Magnussen P, 2004. Trends in malaria-attributable morbidity and mortality among young children admitted to Ugandan hospitals, for the period 1990–2001. Ann Trop Med Parasitol 98 :315–327.
-
16
Hinderaker SG, Olsen BE, Bergsjo P, Lie RT, Gasheka P, Kvale G, 2001. Anemia in pregnancy in the highlands of Tanzania. Acta Obstet Gynecol Scand 80 :18–26.
-
17
Lindblade KA, O’Neill DB, Mathanga DP, Katungu J, Wilson ML, 2000. Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health 5 :865–875.
-
18
Ministry of Health U, 2000. Extent of the malaria problem; Morbidity and Mortality. Uganda Malaria Control Policy. Uganda Ministry of Health. Kampala, 3–5.
-
19
Najera JA, Kousnetsov RL, Delacollete C, 1998. Malaria epidemics: detection and control, forecasting and prevention. WHO/MAL/98. Geneva: World Health Organization.
-
20
Cullen JR, Chitprarop U, Doberstyn EB, Sombatwattanangkul K, 1984. An epidemiological early warning system for malaria control in northern Thailand. Bull WHO 62 :107–114.
-
21
Centers for Disease Control and Prevention, 1989. Proposed changes in format for the presentation of notifiable disease report data. MMWR Morb Mortal Wkly Rep 38 :805–809.
-
22
Greenwood BM, 1997. The epidemiology of malaria. Ann Trop Med Parasitol 91 :763–769.
-
23
Snow RW, Craig M, Deichmann U, Marsh K, 1999. Estimating mortality, morbidity and disability due to malaria among Africa’s non-pregnant population. Bull WHO 77 :624–640.
-
24
Whitworth J, Morgan D, Quigley M, Smith A, Mayanja B, Eotu H, Omoding N, Okongo M, Malamba S, Ojwiya A, 2000. Effect of HIV-1 and increasing immunosuppression on malaria parasitaemia and clinical episodes in adults in rural Uganda: a cohort study. Lancet 356 :1051–1056.
-
25
Chirenda J, Siziya S, Tshimanga M, 2000. Association of HIV infection with the development of severe and complicated malaria cases at a rural hospital in Zimbabwe. Cent Afr J Med 46 :5–9.
-
26
Grimwade K, French N, Mbatha DD, Zungu DD, Dedicoat M, Gilks CF, 2004. HIV infection as a cofactor for severe falciparum malaria in adults living in a region of unstable malaria transmission in South Africa. AIDS 18 :547–554.
-
27
Mockenhaupt FP, Ehrhardt S, Burkhardt J, Bosomtwe SY, Laryea S, Anemana SD, Otchwemah RN, Cramer JP, Dietz E, Gellert S, Bienzle U, 2004. Manifestation and outcome of severe malaria in children in northern Ghana. Am J Trop Med Hyg 71 :167–172.
-
28
Modiano D, Sirima BS, Sawadogo A, Sanou I, Pare J, Konate A, Pagnoni F, 1998. Severe malaria in Burkina Faso: influence of age and transmission level on clinical presentation. Am J Trop Med Hyg 59 :539–542.
-
29
Marsh K, Forster D, Waruiru C, Mwangi I, Winstanley M, Marsh V, Newton C, Winstanley P, Warn P, Peshu N, Pasvol G, Snow R, 1995. Indicators of life-threatening malaria in African children. N Engl J Med 332 :1399–1404.
-
30
Snow RW, Omumbo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, Newbold C, Gupta S, Marsh K, 1997. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet 349 :1650–1654.
-
31
Marsh K, Snow RW, 1997. Host-parasite interaction and morbidity in malaria endemic areas. Philos Trans R Soc Lond B Biol Sci 352 :1385–1394.
-
32
Waitumbi JN, Donvito B, Kisserli A, Cohen JH, Stoute JA, 2004. Age-related changes in red blood cell complement regulatory proteins and susceptibility to severe malaria. J Infect Dis 190 :1183–1191.
-
33
Weatherall DJ, Abdalla S, Pippard MJ, 1983. The anaemia of Plasmodium falciparum malaria. Ciba Found Symp 94 :74–97.
-
34
Gupta S, Snow RW, Donnelly C, Newbold C, 1999. Acquired immunity and postnatal clinical protection in childhood cerebral malaria. Proc R Soc Lond B Biol Sci 266 :33–38.
-
35
Seboxa T, Snow RW, 1997. Epidemiological features of severe paediatric malaria in north western Ethiopia. East Afr Med J 74 :780–783.
-
36
Idro R, Aloyo J, 2004. Manifestations, quality of emergency care and outcome of severe malaria in mulago hospital, Uganda. Afr Health Sci 4 :50–57.
-
37
Anstey NM, Jacups SP, Cain T, Pearson T, Ziesing PJ, Fisher DA, Currie BJ, Marks PJ, Maguire GP, 2002. Pulmonary manifestations of uncomplicated falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis 185 :1326–1334.
-
38
Gozal D, 1992. The incidence of pulmonary manifestations during Plasmodium falciparum malaria in non immune subjects. Trop Med Parasitol 43 :6–8.
-
39
O’Dempsey TJ, McArdle TF, Laurence BE, Lamont AC, Todd JE, Greenwood BM, 1993. Overlap in the clinical features of pneumonia and malaria in African children. Trans R Soc Trop Med Hyg 87 :662–665.
-
40
Perkins BA, Zucker JR, Otieno J, Jafari HS, Paxton L, Redd SC, Nahlen BL, Schwartz B, Oloo AJ, Olango C, Gove S, Campbell CC, 1997. Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission. Bull WHO 75 :33–42.
-
41
Redd SC, Bloland PB, Kazembe PN, Patrick E, Tembenu R, Campbell CC, 1992. Usefulness of clinical case-definitions in guiding therapy for African children with malaria or pneumonia. Lancet 340 :1140–1143.
-
42
English M, Sauerwein R, Waruiru C, Mosobo M, Obiero J, Lowe B, Marsh K, 1997. Acidosis in severe childhood malaria. QJM 90 :263–270.
-
43
Muhe L, Oljira B, Degefu H, Enquesellassie F, Weber MW, 1999. Clinical algorithm for malaria during low and high transmission seasons. Arch Dis Child 81 :216–220.
-
44
Idro R, Karamagi C, Tumwine J, 2004. Immediate outcome and prognostic factors for cerebral malaria among children admitted to Mulago Hospital, Uganda. Ann Trop Paediatr 24 :17–24.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 201 | 155 | 5 |
| Full Text Views | 386 | 4 | 0 |
| PDF Downloads | 73 | 4 | 0 |
CLINICAL MANIFESTATIONS OF SEVERE MALARIA IN THE HIGHLANDS OF SOUTHWESTERN UGANDA
RICHARD IDRO
RICHARD IDRO
Department of Pediatrics and Child Health, Makerere University Medical School/Mulago Hospital, Kampala, Uganda; Kabale Regional Referral Hospital, Kabale, Uganda; Rainbow Center for International Child Health, Rainbow Babies and Children’s Hospital, Cleveland, Ohio; Division of Pediatric Infectious Disease and Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio
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EDWARD BITARAKWATE
EDWARD BITARAKWATE
Department of Pediatrics and Child Health, Makerere University Medical School/Mulago Hospital, Kampala, Uganda; Kabale Regional Referral Hospital, Kabale, Uganda; Rainbow Center for International Child Health, Rainbow Babies and Children’s Hospital, Cleveland, Ohio; Division of Pediatric Infectious Disease and Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio
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SAM TUMWESIGIRE
SAM TUMWESIGIRE
Department of Pediatrics and Child Health, Makerere University Medical School/Mulago Hospital, Kampala, Uganda; Kabale Regional Referral Hospital, Kabale, Uganda; Rainbow Center for International Child Health, Rainbow Babies and Children’s Hospital, Cleveland, Ohio; Division of Pediatric Infectious Disease and Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio
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CHANDY C. JOHN
CHANDY C. JOHN
Department of Pediatrics and Child Health, Makerere University Medical School/Mulago Hospital, Kampala, Uganda; Kabale Regional Referral Hospital, Kabale, Uganda; Rainbow Center for International Child Health, Rainbow Babies and Children’s Hospital, Cleveland, Ohio; Division of Pediatric Infectious Disease and Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Epidemics of malaria have occurred in highland areas of East Africa since the 1980s, but the clinical spectrum of severe malaria in these areas has not been described. Over a 17-month period from 2001 to 2002, we assessed 117 consecutive patients admitted to Kabale Hospital in highland Uganda who met the World Health Organization 2000 criteria for severe malaria. Sixty-six persons (56.4%) were age 5 years or older, and 51 (43.6%) were under 5 years of age. Fever, vomiting, and cough were the most frequent symptoms. Hepatomegaly and splenomegaly were infrequent. Prostration was the most frequent manifestation of severe malaria in children under 5 years of age (45.1%) and persons 5 years or older (65.2%), followed by respiratory distress (29.4%) and severe anemia (19.6%) in children under 5 years, and respiratory distress (15.2%) and impaired consciousness (13.6%) in persons 5 years or older. Strictly defined cerebral malaria was uncommon (3.4%). In a multivariate regression model, children under 5 years were more likely than persons 5 years or older to present with severe anemia (OR 5.2, 95% confidence interval [CI] 1.2–21.9) and respiratory distress (OR 3.5, 95% CI 1.3–11.1) and less likely to present with prostration (OR 0.3, 95% CI 0.1–0.7) and impaired consciousness (OR 0.2, 95% CI 0.0–0.9). In highland Uganda, severe malaria often occurs in persons older than 5 years of age. “Typical” signs like splenomegaly are frequently absent, prostration is the major manifestation, and other manifestations vary in frequency according to age.
Author Notes
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Breman JG, 2001. The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg 64 :1–11.
-
2
2000. Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster. Trans R Soc Trop Med Hyg 94 (Suppl 1):S1–90.
-
3
Minakawa N, Sonye G, Mogi M, Githeko A, Yan G, 2002. The effects of climatic factors on the distribution and abundance of malaria vectors in Kenya. J Med Entomol 39 :833–841.
-
4
Lindblade KA, Walker ED, Onapa AW, Katungu J, Wilson ML, 1999. Highland malaria in Uganda: prospective analysis of an epidemic associated with El Nino. Trans R Soc Trop Med Hyg 93 :480–487.
-
5
John CC, Sumba PO, Ouma JH, Nahlen BL, King CL, Kazura JW, 2000. Cytokine responses to Plasmodium falciparum liver-stage antigen 1 vary in rainy and dry seasons in highland Kenya. Infect Immun 68 :5198–5204.
-
6
John CC, Ouma JH, Sumba PO, Hollingdale MR, Kazura JW, King CL, 2002. Lymphocyte proliferation and antibody responses to Plasmodium falciparum liver-stage antigen-1 in a highland area of Kenya with seasonal variation in malaria transmission. Am J Trop Med Hyg 66 :372–378.
-
7
Hay SI, Noor AM, Simba M, Busolo M, Guyatt HL, Ochola SA, Snow RW, 2002. Clinical epidemiology of malaria in the highlands of western Kenya. Emerg Infect Dis 8 :543–548.
-
8
Ndyomugyenyi R, Magnussen P, 2001. Malaria morbidity, mortality and pregnancy outcome in areas with different levels of malaria transmission in Uganda: a hospital record-based study. Trans R Soc Trop Med Hyg 95 :463–468.
-
9
Lindblade KA, O’Neill DB, Mathanga DP, Katungu J, Wilson ML, 2000. Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health 5 :865–875.
-
10
Lindblade KA, Walker ED, Wilson ML, 2000. Early warning of malaria epidemics in African highlands using Anopheles (Diptera: Culicidae) indoor resting density. J Med Entomol 37 :664–674.
-
11
Shanks GD, Hay SI, Stern DI, Biomndo K, Snow RW, 2002. Meteorologic influences on Plasmodium falciparum malaria in the Highland Tea Estates of Kericho, Western Kenya. Emerg Infect Dis 8 :1404–1408.
-
12
Lindblade KA, Walker ED, Onapa AW, Katungu J, Wilson ML, 2000. Land use change alters malaria transmission parameters by modifying temperature in a highland area of Uganda. Trop Med Int Health 5 :263–274.
-
13
Cox J, Craig M, LeSueur D, Sharp B, 1999. Mapping malaria risk in the highlands of Africa. London, UK: MARA/HIMAL, 114.
-
14
Esamai F, Nabakwe E, Mining S, Forsberg P, Lewis DH, 1999. Clinical presentation and diagnosis of cerebral malaria in children in the highlands of western Kenya. East Afr Med J 76 :89–92.
-
15
Ndyomugyenyi R, Magnussen P, 2004. Trends in malaria-attributable morbidity and mortality among young children admitted to Ugandan hospitals, for the period 1990–2001. Ann Trop Med Parasitol 98 :315–327.
-
16
Hinderaker SG, Olsen BE, Bergsjo P, Lie RT, Gasheka P, Kvale G, 2001. Anemia in pregnancy in the highlands of Tanzania. Acta Obstet Gynecol Scand 80 :18–26.
-
17
Lindblade KA, O’Neill DB, Mathanga DP, Katungu J, Wilson ML, 2000. Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health 5 :865–875.
-
18
Ministry of Health U, 2000. Extent of the malaria problem; Morbidity and Mortality. Uganda Malaria Control Policy. Uganda Ministry of Health. Kampala, 3–5.
-
19
Najera JA, Kousnetsov RL, Delacollete C, 1998. Malaria epidemics: detection and control, forecasting and prevention. WHO/MAL/98. Geneva: World Health Organization.
-
20
Cullen JR, Chitprarop U, Doberstyn EB, Sombatwattanangkul K, 1984. An epidemiological early warning system for malaria control in northern Thailand. Bull WHO 62 :107–114.
-
21
Centers for Disease Control and Prevention, 1989. Proposed changes in format for the presentation of notifiable disease report data. MMWR Morb Mortal Wkly Rep 38 :805–809.
-
22
Greenwood BM, 1997. The epidemiology of malaria. Ann Trop Med Parasitol 91 :763–769.
-
23
Snow RW, Craig M, Deichmann U, Marsh K, 1999. Estimating mortality, morbidity and disability due to malaria among Africa’s non-pregnant population. Bull WHO 77 :624–640.
-
24
Whitworth J, Morgan D, Quigley M, Smith A, Mayanja B, Eotu H, Omoding N, Okongo M, Malamba S, Ojwiya A, 2000. Effect of HIV-1 and increasing immunosuppression on malaria parasitaemia and clinical episodes in adults in rural Uganda: a cohort study. Lancet 356 :1051–1056.
-
25
Chirenda J, Siziya S, Tshimanga M, 2000. Association of HIV infection with the development of severe and complicated malaria cases at a rural hospital in Zimbabwe. Cent Afr J Med 46 :5–9.
-
26
Grimwade K, French N, Mbatha DD, Zungu DD, Dedicoat M, Gilks CF, 2004. HIV infection as a cofactor for severe falciparum malaria in adults living in a region of unstable malaria transmission in South Africa. AIDS 18 :547–554.
-
27
Mockenhaupt FP, Ehrhardt S, Burkhardt J, Bosomtwe SY, Laryea S, Anemana SD, Otchwemah RN, Cramer JP, Dietz E, Gellert S, Bienzle U, 2004. Manifestation and outcome of severe malaria in children in northern Ghana. Am J Trop Med Hyg 71 :167–172.
-
28
Modiano D, Sirima BS, Sawadogo A, Sanou I, Pare J, Konate A, Pagnoni F, 1998. Severe malaria in Burkina Faso: influence of age and transmission level on clinical presentation. Am J Trop Med Hyg 59 :539–542.
-
29
Marsh K, Forster D, Waruiru C, Mwangi I, Winstanley M, Marsh V, Newton C, Winstanley P, Warn P, Peshu N, Pasvol G, Snow R, 1995. Indicators of life-threatening malaria in African children. N Engl J Med 332 :1399–1404.
-
30
Snow RW, Omumbo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, Newbold C, Gupta S, Marsh K, 1997. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet 349 :1650–1654.
-
31
Marsh K, Snow RW, 1997. Host-parasite interaction and morbidity in malaria endemic areas. Philos Trans R Soc Lond B Biol Sci 352 :1385–1394.
-
32
Waitumbi JN, Donvito B, Kisserli A, Cohen JH, Stoute JA, 2004. Age-related changes in red blood cell complement regulatory proteins and susceptibility to severe malaria. J Infect Dis 190 :1183–1191.
-
33
Weatherall DJ, Abdalla S, Pippard MJ, 1983. The anaemia of Plasmodium falciparum malaria. Ciba Found Symp 94 :74–97.
-
34
Gupta S, Snow RW, Donnelly C, Newbold C, 1999. Acquired immunity and postnatal clinical protection in childhood cerebral malaria. Proc R Soc Lond B Biol Sci 266 :33–38.
-
35
Seboxa T, Snow RW, 1997. Epidemiological features of severe paediatric malaria in north western Ethiopia. East Afr Med J 74 :780–783.
-
36
Idro R, Aloyo J, 2004. Manifestations, quality of emergency care and outcome of severe malaria in mulago hospital, Uganda. Afr Health Sci 4 :50–57.
-
37
Anstey NM, Jacups SP, Cain T, Pearson T, Ziesing PJ, Fisher DA, Currie BJ, Marks PJ, Maguire GP, 2002. Pulmonary manifestations of uncomplicated falciparum and vivax malaria: cough, small airways obstruction, impaired gas transfer, and increased pulmonary phagocytic activity. J Infect Dis 185 :1326–1334.
-
38
Gozal D, 1992. The incidence of pulmonary manifestations during Plasmodium falciparum malaria in non immune subjects. Trop Med Parasitol 43 :6–8.
-
39
O’Dempsey TJ, McArdle TF, Laurence BE, Lamont AC, Todd JE, Greenwood BM, 1993. Overlap in the clinical features of pneumonia and malaria in African children. Trans R Soc Trop Med Hyg 87 :662–665.
-
40
Perkins BA, Zucker JR, Otieno J, Jafari HS, Paxton L, Redd SC, Nahlen BL, Schwartz B, Oloo AJ, Olango C, Gove S, Campbell CC, 1997. Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission. Bull WHO 75 :33–42.
-
41
Redd SC, Bloland PB, Kazembe PN, Patrick E, Tembenu R, Campbell CC, 1992. Usefulness of clinical case-definitions in guiding therapy for African children with malaria or pneumonia. Lancet 340 :1140–1143.
-
42
English M, Sauerwein R, Waruiru C, Mosobo M, Obiero J, Lowe B, Marsh K, 1997. Acidosis in severe childhood malaria. QJM 90 :263–270.
-
43
Muhe L, Oljira B, Degefu H, Enquesellassie F, Weber MW, 1999. Clinical algorithm for malaria during low and high transmission seasons. Arch Dis Child 81 :216–220.
-
44
Idro R, Karamagi C, Tumwine J, 2004. Immediate outcome and prognostic factors for cerebral malaria among children admitted to Mulago Hospital, Uganda. Ann Trop Paediatr 24 :17–24.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 201 | 155 | 5 |
| Full Text Views | 386 | 4 | 0 |
| PDF Downloads | 73 | 4 | 0 |