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Pediatric malaria

Prashant P Kadam, Nithya Jaideep Gogtay, Sunil Karande, V Shah, Urmila M Thatte
OBJECTIVES: Studies on antimalarial kinetics in children or adults who are undernourished or malnourished are both limited and have yielded conflicting results. The present study was carried out with the objectives of evaluating the pharmacokinetics of single dose chloroquine and its metabolite desethylchloroquine in children who were undernourished and compare them with children who were normally nourished. METHODS: Children of either gender between the ages of 5 and 12 years, smear positive for P...
September 2016: Indian Journal of Pharmacology
Andrea L Conroy, Michael Hawkes, Chloe R McDonald, Hani Kim, Sarah J Higgins, Kevin R Barker, Sophie Namasopo, Robert O Opoka, Chandy C John, W Conrad Liles, Kevin C Kain
Background.  Host responses to infection are critical determinants of disease severity and clinical outcome. The development of tools to risk stratify children with malaria is needed to identify children most likely to benefit from targeted interventions. Methods.  This study investigated the kinetics of candidate biomarkers of mortality associated with endothelial activation and dysfunction (angiopoietin-2 [Ang-2], soluble FMS-like tyrosine kinase-1 [sFlt-1], and soluble intercellular adhesion molecule-1 [sICAM-1]) and inflammation (10 kDa interferon γ-induced protein [CXCL10/IP-10] and soluble triggering receptor expressed on myeloid cells-1 [sTREM-1]) in the context of a randomized, double-blind, placebo-controlled, parallel-arm trial evaluating inhaled nitric oxide versus placebo as adjunctive therapy to parenteral artesunate for severe malaria...
September 2016: Open Forum Infectious Diseases
Ann M Moormann, Jeffrey A Bailey
Burkitt lymphoma (BL) is >90% EBV-associated when this pediatric cancer is diagnosed in regions heavily burden by endemic Plasmodium falciparum malaria and thus has been geographically classified as endemic BL. The incidence of endemic BL is 10-fold higher compared to BL diagnosed in non-malarious regions of the world. The other forms of BL have been classified as sporadic BL which contain EBV in ∼30% of cases and immunodeficiency BL which occurs in HIV-infected adults with ∼40% of tumors containing EBV...
September 26, 2016: Current Opinion in Virology
Sheetal Gupta, Ghanshyam Singh Sengar, Praveen K Meti, Anil Lahoti, Mukesh Beniwal, Murlidhar Kumawat
OBJECTIVE: To determine incidence, risk factors, and outcome of acute kidney injury (AKI) in Pediatric Intensive Care Unit (PICU). MATERIALS AND METHODS: This is a prospective, observational study conducted in PICU of Department of Paediatrics, S.P. Medical College, Bikaner, from October 2013 to May 2014. In this study, 536 patients of aged 29 days to 16 years were screened for AKI according to the Pediatric Risk, Injury, Failure, Loss, End-stage Renal Disease (pRIFLE) criteria...
September 2016: Indian Journal of Critical Care Medicine
Mandingha Kosso Etoka-Beka, Francine Ntoumi, Michael Kombo, Julia Deibert, Pierre Poulain, Christevy Vouvoungui, Simon Charles Kobawila, Felix Koukouikila-Koussounda
OBJECTIVES: To investigate the proportion of malaria infection in febrile children consulting a paediatric hospital in Brazzaville, to determine the prevalence of submicroscopic malaria infection, to characterise Plasmodium falciparum infection and compare the prevalence of uncomplicated P. falciparum malaria according to haemoglobin profiles. METHODS: Blood samples were collected from children aged <10 years with an axillary temperature ≥37.5 °C consulting the paediatric ward of Marien Ngouabi Hospital in Brazzaville...
September 27, 2016: Tropical Medicine & International Health: TM & IH
Fredrick Ibinda, Hans-Christoph Zarnack, Charles R Newton
BACKGROUND: Perturbations of blood sodium are the most frequently encountered electrolyte disorder in sick children, and may influence fluid therapy. We examined the frequency of blood sodium perturbations, and factors and outcomes associated with hyponatremia in children admitted to a rural Kenyan hospital and investigated the risk factors associated with deaths in hyponatremic children. METHODS: Plasma sodium levels and other laboratory parameters were measured in children admitted to a rural Kenyan hospital...
2016: PloS One
Prakasha Kempaiah, Karol Dokladny, Zachary Karim, Evans Raballah, John M Ong'echa, Pope L Moseley, Douglas J Perkins
Severe malarial anemia [SMA, hemoglobin (Hb) <5.0 g/dL] is a leading cause of global morbidity and mortality among children residing in Plasmodium falciparum transmission regions. Exploration of molecular pathways through global gene expression profiling revealed that SMA was characterized by decreased HSPA1A, a heat shock protein (Hsp) 70 coding gene. Hsp70 is a ubiquitous chaperone that regulates Nuclear Factor-kappa B (NF-κB) signaling and production of pro-inflammatory cytokines known to be important in malaria pathogenesis (e...
August 30, 2016: Molecular Medicine
Aggrey Dhabangi, Brenda Ainomugisha, Christine Cserti-Gazdewich, Henry Ddungu, Dorothy Kyeyune, Ezra Musisi, Robert Opoka, Christopher P Stowell, Walter H Dzik
Importance: Severe anemia, defined as a hemoglobin level of less than 5.0 g/dL, affects millions of children worldwide. The brain has a high basal demand for oxygen and is especially vulnerable to hypoxemia. Previous studies have documented neurocognitive impairment in children with severe anemia. Data on cerebral tissue oxygenation in children with severe anemia and their response to blood transfusion are limited. Objective: To measure hemoglobin saturation in cerebral tissue (cerebral tissue oxygen saturation [tSo2]) before, during, and after blood transfusion in a cohort of children presenting to hospital with severe anemia...
October 1, 2016: JAMA Pediatrics
Wen Lin, Tycho Heimbach, Jay Prakash Jain, Rakesh Awasthi, Kamal Hamed, Gangadhar Sunkara, Handan He
Artemether is co-administered with lumefantrine as part of a fixed-dose combination therapy for malaria in both adult and pediatric patients. However, artemether exposure is higher in younger infants (1-3 months) with a lower body weight (<5 kg) as compared to older infants (3-6 months) with a higher body weight (≥5 to <10 kg), children, and adults. In contrast, lumefantrine exposure is similar in all age groups. This article describes the clinically observed artemether exposure data in pediatric populations across various age groups (1 month to 12 years) and body weights (<5 or ≥5 kg) using physiologically based pharmacokinetic (PBPK) mechanistic models...
October 2016: Journal of Pharmaceutical Sciences
Sydney Maghendji-Nzondo, Hermann Nzoughe, Guy Joseph Lemamy, Lady Charlene Kouna, Irene Pegha-Moukandja, Faustin Lekoulou, Bertrand Mbatchi, Fousseyni Toure-Ndouo, Jean Bernard Lekana-Douki
Recently, major progress has been made in controlling malaria in Africa. However, in Gabon, little information is available on the role of malaria in childhood febrile syndromes, the use and efficacy of preventive measures, and Plasmodium species distribution. Here, we characterized malaria in febrile children in Franceville, Gabon through a cross-sectional study at the pediatric unit of the Franceville Regional Hospital. We registered 940 febrile children. Their general condition was markedly altered in 11...
2016: Parasite: Journal de la Société Française de Parasitologie
Andrea L Conroy, Michael Hawkes, Robyn E Elphinstone, Catherine Morgan, Laura Hermann, Kevin R Barker, Sophie Namasopo, Robert O Opoka, Chandy C John, W Conrad Liles, Kevin C Kain
Background.  Acute kidney injury (AKI) is a well recognized complication of severe malaria in adults, but the incidence and clinical importance of AKI in pediatric severe malaria (SM) is not well documented. Methods.  One hundred eighty children aged 1 to 10 years with SM were enrolled between 2011 and 2013 in Uganda. Kidney function was monitored daily for 4 days using serum creatinine (Cr). Acute kidney injury was defined using the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Blood urea nitrogen (BUN) and Cr were assessed using i-STAT, and cystatin C (CysC) was measured by enzyme-linked immunosorbent assay...
March 2016: Open Forum Infectious Diseases
Maria Bernabeu, Samuel A Danziger, Marion Avril, Marina Vaz, Prasad H Babar, Andrew J Brazier, Thurston Herricks, Jennifer N Maki, Ligia Pereira, Anjali Mascarenhas, Edwin Gomes, Laura Chery, John D Aitchison, Pradipsinh K Rathod, Joseph D Smith
The interplay between cellular and molecular determinants that lead to severe malaria in adults is unexplored. Here, we analyzed parasite virulence factors in an infected adult population in India and investigated whether severe malaria isolates impair endothelial protein C receptor (EPCR), a protein involved in coagulation and endothelial barrier permeability. Severe malaria isolates overexpressed specific members of the Plasmodium falciparum var gene/PfEMP1 (P. falciparum erythrocyte membrane protein 1) family that bind EPCR, including DC8 var genes that have previously been linked to severe pediatric malaria...
June 7, 2016: Proceedings of the National Academy of Sciences of the United States of America
Imelda K Moise, Shouraseni Sen Roy, Delphin Nkengurutse, Jacques Ndikubagenzi
We analyzed hospitalization records from 2011 to 2012 to examine the spatial patterns of pediatric malaria in Burundi. Malaria case data for those below the age of five years were categorized according to the four principal seasons of Burundi, which are two rainy seasons (February to May; September to November) and two dry seasons (June to August; December to January). The Getis-Ord Gi* statistic was used to examine seasonal spatial patterns of pediatric malaria, whereas geographically weighted regression (GWR) were used to examine the potential role of environmental variables on the spatial patterns of cases...
April 2016: International Journal of Environmental Research and Public Health
Luke R Smart, Neema Orgenes, Humphrey D Mazigo, Mercy Minde, Adolfine Hokororo, Muhammad Shakir, Jaco J Verweij, Jennifer A Downs, Robert N Peck
Malaria remains common in sub-Saharan Africa, but it is frequently over-diagnosed and over-treated in hospitalized children. HIV is prevalent in many malaria endemic areas and may delay parasite clearance and increase mortality among children with malaria. This prospective cohort study enrolled children with suspected malaria between 3 months and 12 years of age hospitalized at two referral hospitals in Tanzania. Both a thick blood smear (BS) and a malaria rapid diagnostic test (mRDT) were performed. If discordant results were obtained, PCR was performed for Plasmodium falciparum...
July 2016: Acta Tropica
Santosh Kumar Rathia, Jhuma Sankar, Devasenathipathy Kandasamy, Rakesh Lodha
Cerebral malaria is a well-known complication of Plasmodium falciparum malaria. Over recent years, however, Plasmodium vivax also has been reported to cause cerebral malaria with or without co-infection with P. falciparum Here, we report a boy aged 10 years presenting with acute febrile encephalopathy with raised intracranial pressure to the emergency, who was later diagnosed to have P. vivax malaria. His neurological status improved gradually during 6 weeks of pediatric intensive care unit stay. We report this case to highlight the unusual radiologic findings in the patient, such as multifocal hemorrhagic infarcts in the brainstem, bilateral thalami, frontal cortex and basal ganglia, which have not been reported with P...
August 2016: Journal of Tropical Pediatrics
Nasim Lowlaavar, Charles P Larson, Elias Kumbakumba, Guohai Zhou, J Mark Ansermino, Joel Singer, Niranjan Kissoon, Hubert Wong, Andrew Ndamira, Jerome Kabakyenga, Julius Kiwanuka, Matthew O Wiens
BACKGROUND: Pediatric hospital mortality from infectious diseases in resource constrained countries remains unacceptably high. Improved methods of risk-stratification can assist in referral decision making and resource allocation. The purpose of this study was to create prediction models for in-hospital mortality among children admitted with suspected infectious diseases. METHODS: This two-site prospective observational study enrolled children between 6 months and 5 years admitted with a proven or suspected infection...
2016: PloS One
Regina Joice, Charles Frantzreb, Alana Pradham, Karl B Seydel, Steve Kamiza, Dyann F Wirth, Manoj T Duraisingh, Malcolm E Molyneux, Terrie E Taylor, Matthias Marti, Danny A Milner
The spleen has an important role in the clearance of malaria parasites, and the role of HIV co-infection on this process is yet to be described. Using a combination of histological and molecular methods, we systematically evaluated parasite load across multiple organs from HIV-positive and HIV-negative cases of an autopsy study of pediatric comatose children with malaria infection (n=103) in Blantyre, Malawi. Quantification of parasite load across organs was done using histology. A subset of cases was further characterized for parasite localization and stage of development using immunohistochemistry-based labeling of parasite and host cells (5 HIV-positive, 10 HIV-negative), and quantitative RT-PCR (qRT-PCR) of asexual and sexual-specific genes (4 HIV-positive, 5 HIV-negative)...
April 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Hubert Barennes, Eng Sayavong, Eric Pussard
INTRODUCTION: Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. METHODS: Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI)...
2016: PloS One
A Brembilla, F Mauny, A Garcia, K G Koura, P Deloron, J-F Faucher
Data centered on antibiotics usage and their determinants in African pediatric populations are limited. In order to define the determinants of antibiotics prescriptions (ABPr), we analyzed the data of a birth cohort in Benin. From 2007 to 2009, 538 infants were followed from birth to 18 months in three different health centers. The following determinants were assessed: infants' clinical findings at consultations, mothers' and children's characteristics at birth, and health parameters recorded at scheduled follow-up of general health parameters...
April 2016: European Journal of Clinical Microbiology & Infectious Diseases
Sarah E Hochman, Theresa F Madaline, Samuel C Wassmer, Emmie Mbale, Namjong Choi, Karl B Seydel, Richard O Whitten, Julie Varughese, Georges E R Grau, Steve Kamiza, Malcolm E Molyneux, Terrie E Taylor, Sunhee Lee, Danny A Milner, Kami Kim
No abstract text is available yet for this article.
2016: MBio
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