Characteristics of Travel-Related Severe Plasmodium vivax and Plasmodium falciparum Malaria in Individuals Hospitalized at a Tertiary Referral Center in Lima, Peru.
Severe Plasmodium falciparum 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. Plasmodium vivax was most commonly identified (71%) among the severe infections, followed by P. falciparum (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%). Plasmodium vivax mono-infection predominated as the etiology of SM in cases acquired in Peru.
Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
Fiorella
F
Llanos-Chea
Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
Dalila
D
Martínez
Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
Angel
A
Rosas
Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
Frine
F
Samalvides
Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California jvinetz@ucsd.edu.
Joseph M
JM
Vinetz
Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California.
Alejandro
A
Llanos-Cuentas
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D006760:Hospitalization; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014195:Travel; D055815:Young Adult