31 results on '"Sugiarto, Paulus"'
Search Results
2. Intravenous artesunate plus oral dihydroartemisinin–piperaquine or intravenous quinine plus oral quinine for optimum treatment of severe malaria: lesson learnt from a field hospital in Timika, Papua, Indonesia
- Author
-
Sikora, Silvester Alexandro, Poespoprodjo, Jeanne Rini, Kenangalem, Enny, Lampah, Daniel A., Sugiarto, Paulus, Laksono, Ida Safitri, Ahmad, Riris Andono, and Murhandarwati, E. Elsa Herdiana
- Published
- 2019
- Full Text
- View/download PDF
3. Early and late mortality after malaria in young children in Papua, Indonesia
- Author
-
Patriani, Dewi, Arguni, Eggi, Kenangalem, Enny, Dini, Saber, Sugiarto, Paulus, Hasanuddin, Afdhal, Lampah, Daniel Adrian, Douglas, Nicholas M., Anstey, Nicholas M., Simpson, Julie Anne, Price, Ric N., and Poespoprodjo, Jeanne Rini
- Published
- 2019
- Full Text
- View/download PDF
4. Safety of primaquine in infants with Plasmodium vivax malaria in Papua, Indonesia
- Author
-
Setyadi, Agus, Arguni, Eggi, Kenangalem, Enny, Hasanuddin, Afdhal, Lampah, Daniel A., Thriemer, Kamala, Anstey, Nicholas M., Sugiarto, Paulus, Simpson, Julie A., Price, Ric N., Douglas, Nicholas M., and Poespoprodjo, Jeanne R.
- Published
- 2019
- Full Text
- View/download PDF
5. Severe Malarial Thrombocytopenia: A Risk Factor for Mortality in Papua, Indonesia
- Author
-
Lampah, Daniel A., Yeo, Tsin W., Malloy, Michael, Kenangalem, Enny, Douglas, Nicholas M., Ronaldo, Donny, Sugiarto, Paulus, Simpson, Julie A., Poespoprodjo, Jeanne Rini, Anstey, Nicholas M., and Price, Ric N.
- Published
- 2015
6. Malaria morbidity and mortality following introduction of a universal policy of artemisinin-based treatment for malaria in Papua, Indonesia: A longitudinal surveillance study
- Author
-
Kenangalem, Enny, Poespoprodjo, Jeanne Rini, Douglas, Nicholas M., Burdam, Faustina Helena, Gdeumana, Ketut, Chalfein, Ferry, Prayoga, Thio, Franciscus, Devine, Angela, Marfurt, Jutta, Waramori, Govert, Yeung, Shunmay, Noviyanti, Rintis, Penttinen, Pasi, Bangs, Michael J., Sugiarto, Paulus, Simpson, Julie A., Soenarto, Yati, Anstey, Nicholas M., and Price, Ric N.
- Subjects
Artemisinin -- Usage ,Longitudinal studies -- Usage ,Malaria -- Drug therapy -- Control -- Patient outcomes -- Risk factors ,Mortality ,Hospital admission and discharge ,Morbidity ,Intelligence gathering ,Plasmodium falciparum ,Liver ,Pyrimethamine ,Biological sciences - Abstract
Background Malaria control activities can have a disproportionately greater impact on Plasmodium falciparum than on P. vivax in areas where both species are coendemic. We investigated temporal trends in malaria-related morbidity and mortality in Papua, Indonesia, before and after introduction of a universal, artemisinin-based antimalarial treatment strategy for all Plasmodium species. Methods and findings A prospective, district-wide malariometric surveillance system was established in April 2004 to record all cases of malaria at community clinics and the regional hospital and maintained until December 2013. In March 2006, antimalarial treatment policy was changed to artemisinin combination therapy for uncomplicated malaria and intravenous artesunate for severe malaria due to any Plasmodium species. Over the study period, a total of 418,238 patients presented to the surveillance facilities with malaria. The proportion of patients with malaria requiring admission to hospital fell from 26.9% (7,745/28,789) in the pre-policy change period (April 2004 to March 2006) to 14.0% (4,786/34,117) in the late transition period (April 2008 to December 2009), a difference of -12.9% (95% confidence interval [CI] -13.5% to -12.2%). There was a significant fall in the mortality of patients presenting to the hospital with P. falciparum malaria (0.53% [100/18,965] versus 0.32% [57/17,691]; difference = -0.21% [95% CI -0.34 to -0.07]) but not in patients with P. vivax malaria (0.28% [21/7,545] versus 0.23% [28/12,397]; difference = -0.05% [95% CI -0.20 to 0.09]). Between the same periods, the overall proportion of malaria due to P. vivax rose from 44.1% (30,444/69,098) to 53.3% (29,934/56,125) in the community clinics and from 32.4% (9,325/28,789) to 44.1% (15,035/34,117) at the hospital. After controlling for population growth and changes in treatment-seeking behaviour, the incidence of P. falciparum malaria fell from 511 to 249 per 1,000 person-years (py) (incidence rate ratio [IRR] = 0.49 [95% CI 0.48-0.49]), whereas the incidence of P. vivax malaria fell from 331 to 239 per 1,000 py (IRR = 0.72 [95% CI 0.71-0.73]). The main limitations of our study were possible confounding from changes in healthcare provision, a growing population, and significant shifts in treatment-seeking behaviour following implementation of a new antimalarial policy. Conclusions In this area with high levels of antimalarial drug resistance, adoption of a universal policy of efficacious artemisinin-based therapy for malaria infections due to any Plasmodium species was associated with a significant reduction in total malaria-attributable morbidity and mortality. The burden of P. falciparum malaria was reduced to a greater extent than that of P. vivax malaria. In coendemic regions, the timely elimination of malaria will require that safe and effective radical cure of both the blood and liver stages of the parasite is widely available for all patients at risk of malaria., Author(s): Enny Kenangalem 1,2, Jeanne Rini Poespoprodjo 1,2,3,4, Nicholas M. Douglas 5, Faustina Helena Burdam 1,2, Ketut Gdeumana 6, Ferry Chalfein 1, Prayoga 1, Franciscus Thio 1,4, Angela Devine 5,7, [...]
- Published
- 2019
- Full Text
- View/download PDF
7. Vivax Malaria: A Major Cause of Morbidity in Early Infancy
- Author
-
Poespoprodjo, Jeanne R., Fobia, Wendelina, Kenangalem, Enny, Lampah, Daniel A., Hasanuddin, Afdal, Warikar, Noah, Sugiarto, Paulus, Tjitra, Emiliana, Anstey, Nick M., and Price, Ric N.
- Published
- 2009
- Full Text
- View/download PDF
8. Adverse Pregnancy Outcomes in an Area Where Multidrug-Resistant Plasmodium vivax and Plasmodium faldparum Infections Are Endemic
- Author
-
Poespoprodjo, Jeanne Rini, Fobia, Wendy, Kenangalem, Enny, Lampah, Daniel A., Warikar, Noah, Seal, Andrew, McGready, Rose, Sugiarto, Paulus, Tjitra, Emiliana, Anstey, Nicholas M., and Price, Ric N.
- Published
- 2008
- Full Text
- View/download PDF
9. Hippocampal atrophy and levels of posterior cingulate cortex (PCC) metabolites in Alzheimer's disease, vascular dementia and normal cognitive
- Author
-
Ferriastuti, Widiana, primary, Notopuro, Harianto, additional, Sensusiati, Anggraini Dwi, additional, and Sugiarto, Paulus, additional
- Published
- 2021
- Full Text
- View/download PDF
10. Multidrug-resistant Plasmodium vivax associated with severe and fatal malaria: a prospective study in Papua, Indonesia
- Author
-
Tjitra, Emiliana, Anstey, Nicholas M., Sugiarto, Paulus, Warikar, Noah, Kenangalem, Enny, Karyana, Muhammad, Lampah, Daniel A., and Price, Ric N.
- Subjects
Biological sciences - Abstract
Background Multidrug-resistant Plosmo&um vivax (Pv) is widespread in eastern Indonesia, and emerging elsewhere in Asia-Pacific and South America, but is generally regarded as a benign disease. The aim of the study was to review the spectrum of disease associated with malaria due to Pv and P. falciparum (Pf) in patients presenting to a hospital in Timika, southern Papua, Indonesia. Methods and Findings Data were prospectively collected from all patients attending the outpatient and inpatient departments of the only hospital in the region using systematic data forms and hospital computerised records. Between January 2004 and December 2007, clinical malaria was present in 16% (60,226/373,450) of hospital outpatients and 32% (12,171/37,800) of inpatients. Among patients admitted with slide-confirmed malaria, 64% of patients had Pf, 24% Pv, and 10.5% mixed infections. The proportion of malarial admissions attributable to Pv rose to 47% (415/ 887) in children under 1 y of age. Severe disease was present in 2,634 (22%) inpatients with malaria, with the risk greater among Pv (23% [675/2,937]) infections compared to Pf (20% [1,570/7,8171; odds ratio [OR] = 1.19 [95% confidence interval (Cl) 1.08-1.32], p = 0.001), and greatest in patients with mixed infections (31% [389/1,273]); overall p < 0.0001. Severe anaemia (haemoglobin < 5 g/dl) was the major complication associated with Pv, accounting for 87% (589/675) of severe disease compared to 73% (1,144/1,570) of severe manifestations with Pf (p < 0.001). Pure Pv infection was also present in 78 patients with respiratory distress and 42 patients with coma. In total 242 (2.0%) patients with malaria died during admission: 2.2% (167/ 7,722) with Pf 1.6% (46/2,916) with Pv, and 2.3% (29/1260) with mixed infections (p = 0.126). Conclusions In this region with established high-grade chloroquine resistance to both Pv and Pf Pv is associated with severe and fatal malaria particularly in young children. The epidemiology of P. Vivax needs to be re-examined elsewhere where chloroquine resistance is increasing. The Editors' Summary of this article follows the references., Introduction The burden of malaria in Asia has been under appreciated, despite recent evidence suggesting that the continent contributes almost 40% of the world's malaria [1]. In sub-Saharan Africa the [...]
- Published
- 2008
11. Unsupervised primaquine for the treatment of Plasmodium vivax malaria relapses in southern Papua: A hospital-based cohort study
- Author
-
Douglas, Nicholas M., Poespoprodjo, Jeanne Rini, Patriani, Dewi, Malloy, Michael J., Kenangalem, Enny, Sugiarto, Paulus, Simpson, Julie A., Soenarto, Yati, Anstey, Nicholas M., and Price, Ric N.
- Subjects
Primaquine -- Dosage and administration ,Malaria -- Drug therapy -- Prevention -- Research ,Treatment outcome -- Analysis ,Biological sciences - Abstract
Background Primaquine is the only licensed drug for eradicating Plasmodium vivax hypnozoites and, therefore, preventing relapses of vivax malaria. It is a vital component of global malaria elimination efforts. Primaquine is efficacious when supervised in clinical trials, but its effectiveness in real-world settings is unknown. We aimed to determine whether unsupervised primaquine was effective for preventing re-presentation to hospital with vivax malaria in southern Papua, Indonesia. Methods and findings Routinely-collected hospital surveillance data were used to undertake a pragmatic comparison of the risk of re-presentation to hospital with vivax malaria in patients prescribed dihydroartemisinin-piperaquine (DHP) combined with primaquine versus those patients prescribed DHP alone. The omission of primaquine was predominantly due to 3 stock outages. Individual clinical, pharmacy, and laboratory data were merged using individual hospital identification numbers and the date of presentation to hospital. Between April 2004 and December 2013, there were 86,797 documented episodes of vivax malaria, of which 62,492 (72.0%) were included in the analysis. The risk of re-presentation with vivax malaria within 1 year was 33.8% (95% confidence Interval [CI] 33.1%-34.5%) after initial monoinfection with P. vivax and 29.2% (95% CI 28.1%-30.4%) after mixed-species infection. The risk of re-presentation with P. vivax malaria was higher in children 1 to Conclusions Unsupervised primaquine for vivax malaria, prescribed according to the current World Health Organization guidelines, was associated with a minimal reduction in the risk of clinical recurrence within 1 year in Papua, Indonesia. New strategies for the effective radical cure of vivax malaria are needed in resource-poor settings., Author(s): Nicholas M. Douglas 1,2, Jeanne Rini Poespoprodjo 3,4, Dewi Patriani 4, Michael J. Malloy 5,6, Enny Kenangalem 3,7, Paulus Sugiarto 8, Julie A. Simpson 5, Yati Soenarto 4, Nicholas [...]
- Published
- 2017
- Full Text
- View/download PDF
12. The risk of adverse clinical outcomes following treatment of Plasmodium vivax malaria with and without primaquine in Papua, Indonesia
- Author
-
Thriemer, Kamala, primary, Poespoprodjo, Jeanne-Rini, additional, Kenangalem, Enny, additional, Douglas, Nicholas M., additional, Sugiarto, Paulus, additional, Anstey, Nicholas M., additional, Simpson, Julie Anne, additional, and Price, Ric N., additional
- Published
- 2020
- Full Text
- View/download PDF
13. Malaria-related hospitalization during childhood in Papua, Indonesia: A retrospective cohort study
- Author
-
Douglas, Nicholas M., primary, Kenangalem, Enny, additional, Hasanuddin, Afdhal, additional, Anstey, Nicholas M., additional, Sugiarto, Paulus, additional, Price, Ric N., additional, and Poespoprodjo, Jeanne Rini, additional
- Published
- 2020
- Full Text
- View/download PDF
14. Malaria morbidity in Papua Indonesia, an area with multidrug resistant Plasmodium vivax and Plasmodium falciparum
- Author
-
Okoseray Maurits J, Vemuri Ram, Umana Ketut Gde, Maristela Rilia, Wariker Noah, Kenangalem Enny, Yeung Shunmay, Burdarm Lenny, Karyana Muhammad, Penttinen Pasi M, Ebsworth Peter, Sugiarto Paulus, Anstey Nicholas M, Tjitra Emiliana, and Price Richard N
- Subjects
Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Multidrug resistance has emerged to both Plasmodium vivax and Plasmodium falciparum and yet the comparative epidemiology of these infections is poorly defined. Methods All laboratory-confirmed episodes of malaria in Timika, Papua, Indonesia, presenting to community primary care clinics and an inpatient facility were reviewed over a two-year period. In addition information was gathered from a house-to-house survey to quantify the prevalence of malaria and treatment-seeking behaviour of people with fever. Results Between January 2004 and December 2005, 99,158 laboratory-confirmed episodes of malaria were reported, of which 58% (57,938) were attributable to P. falciparum and 37% (36,471) to P. vivax. Malaria was most likely to be attributable to pure P. vivax in children under one year of age (55% 2,684/4,889). In the household survey, the prevalence of asexual parasitaemia was 7.5% (290/3,890) for P. falciparum and 6.4% (248/3,890) for P. vivax. The prevalence of P. falciparum infection peaked in young adults aged 15–25 years (9.8% 69/707), compared to P. vivax infection which peaked in children aged 1 to 4 years (9.5% 61/642). Overall 35% (1,813/5,255) of people questioned reported a febrile episode in the preceding month. Of the 60% of people who were estimated to have had malaria, only 39% would have been detected by the surveillance network. The overall incidence of malaria was therefore estimated as 876 per 1,000 per year (Range: 711–906). Conclusion In this region of multidrug-resistant P. vivax and P. falciparum, both species are associated with substantial morbidity, but with significant differences in the age-related risk of infection.
- Published
- 2008
- Full Text
- View/download PDF
15. Major burden of severe anemia from non-falciparum malaria species in Southern Papua: a hospital-based surveillance study
- Author
-
Douglas, Nicholas M., Lampah, Daniel A., Kenangalem, Enny, Simpson, Julie A., Poespoprodjo, Jeanne R., Sugiarto, Paulus, Anstey, Nicholas M., and Price, Ric N.
- Subjects
Medical research ,Medicine, Experimental ,Anemia -- Physiological aspects ,Malaria -- Physiological aspects ,Biological sciences - Abstract
Background: The burden of anemia attributable to non-falciparum malarias in regions with Plasmodium co-endemicity is poorly documented. We compared the hematological profile of patients with and without malaria in southern Papua, Indonesia. Methods and Findings: Clinical and laboratory data were linked for all patients presenting to a referral hospital between April 2004 and December 2012. Data were available on patient demographics, malaria diagnosis, hemoglobin concentration, and clinical outcome, but other potential causes of anemia could not be identified reliably. Of 922,120 patient episodes (837,989 as outpatients and 84,131 as inpatients), a total of 219,845 (23.8%) were associated with a hemoglobin measurement, of whom 67,696 (30.8%) had malaria. Patients with P. malariae infection had the lowest hemoglobin concentration (n = 1,608, mean = 8.93 [95% CI 8.81-9.06]), followed by those with mixed species infections (n = 8,645, mean = 9.22 [95% CI 9.16-9.28]), P. falciparum (n = 37,554, mean = 9.47 [95% CI 9.44-9.50]), and P. vivax (n = 19,858, mean = 9.53 [95% CI 9.49-9.57]); p-value for all comparisons, 0.001. Severe anemia (hemoglobin < 5 g/dl) was present in 8,151 (3.7%) patients. Compared to patients without malaria, those with mixed Plasmodium infection were at greatest risk of severe anemia (adjusted odds ratio [AOR] 3.25 [95% CI 2.99- 3.54]); AORs for severe anaemia associated with P. falciparum, P. vivax, and P. malariae were 2.11 (95% CI 2.00- 2.23), 1.87 (95% CI 1.74-2.01), and 2.18 (95% CI 1.76-2.67), respectively, p < 0.001. Overall, 12.2% (95% CI 11.2%- 13.3%) of severe anemia was attributable to non-falciparum infections compared with 15.1% (95% CI 13.9%-16.3%) for P. falciparum monoinfections. Patients with severe anemia had an increased risk of death (AOR = 5.80 [95% CI 5.17-6.50]; p < 0.001). Not all patients had a hemoglobin measurement, thus limitations of the study include the potential for selection bias, and possible residual confounding in multivariable analyses. Conclusions: In Papua P. vivax is the dominant cause of severe anemia in early infancy, mixed P. vivax/P. falciparum infections are associated with a greater hematological impairment than either species alone, and in adulthood P. malariae, although rare, is associated with the lowest hemoglobin concentration. These findings highlight the public health importance of integrated genus-wide malaria control strategies in areas of Plasmodium co-endemicity. Please see later in the article for the Editors' Summary., Introduction Anemia is a common manifestation of Plasmodium infection and is responsible for substantial morbidity [1-4] as well as direct [5-7] and indirect mortality [8-11]. Its pathogenesis is incompletely understood. [...]
- Published
- 2013
- Full Text
- View/download PDF
16. High Risk of Plasmodium vivax Malaria Following Splenectomy in Papua, Indonesia
- Author
-
Kho, Steven, primary, Andries, Benediktus, additional, Poespoprodjo, Jeanne R, additional, Commons, Robert J, additional, Shanti, Putu A I, additional, Kenangalem, Enny, additional, Douglas, Nicholas M, additional, Simpson, Julie A, additional, Sugiarto, Paulus, additional, Anstey, Nicholas M, additional, and Price, Ric N, additional
- Published
- 2018
- Full Text
- View/download PDF
17. Treatment policy change to dihydroartemisinin-piperaquine contributes to the reduction of adverse maternal and pregnancy outcomes
- Author
-
Poespoprodjo, Jeanne Rini, Fobia, Wendelina, Kenangalem, Enny, Lampah, Daniel A, Sugiarto, Paulus, Tjitra, Emiliana, Anstey, Nicholas M, and Price, Richard N
- Subjects
Adult ,Adolescent ,Research ,Infant, Newborn ,Pregnancy Outcome ,Artemisinins ,Malaria ,Antimalarials ,Young Adult ,Impact ,Infectious Diseases ,Indonesia ,Pregnancy ,Pregnancy Complications, Parasitic ,parasitic diseases ,Quinolines ,Dihydroartemisinin–piperaquine ,Humans ,Maternal malaria ,Female ,Parasitology - Abstract
Background In Papua, Indonesia, maternal malaria is prevalent, multidrug resistant and associated with adverse outcomes for mother and baby. In March 2006, anti-malarial policy was revised for the second and third trimester of pregnancy to dihydroartemisinin–piperaquine (DHP) for all species of malaria. This study presents the temporal analysis of adverse outcomes in pregnancy and early life following this policy change. Methods From April 2004 to May 2010, a standardized questionnaire was used to collect information from all pregnant women admitted to the maternity ward. A physical examination was performed on all live birth newborns. The relative risks (RR) and the associated population attributable risks (PAR) of adverse outcomes in women with a history of malaria treatment to the risk in those without a history of malaria during the current pregnancy were examined to evaluate the temporal trends before and after DHP deployment. Results Of 6,556 women enrolled with known pregnancy outcome, 1,018 (16%) reported prior anti-malarial treatment during their pregnancy. The proportion of women with malaria reporting treatment with DHP rose from 0% in 2004 to 64% (121/189) in 2010. In those with history of malaria during pregnancy, the increasing use of DHP was associated with a 54% fall in the proportion of maternal malaria at delivery and a 98% decrease in congenital malaria (from 7.1% prior to 0.1% after policy change). Overall policy change to more effective treatment was associated with an absolute 2% reduction of maternal severe anaemia and absolute 4.5% decrease in low birth weight babies. Conclusions Introduction of highly effective treatment in pregnancy was associated with a reduction of maternal malaria at delivery and improved neonatal outcomes. Ensuring universal access to arteminisin combination therapy (ACT) in pregnancy in an area of multidrug resistance has potential to impact significantly on maternal and infant health. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0794-0) contains supplementary material, which is available to authorized users.
- Published
- 2015
18. High Risk of Plasmodium vivax Malaria Following Splenectomy in Papua, Indonesia.
- Author
-
Kho, Steven, Andries, Benediktus, Poespoprodjo, Jeanne R, Commons, Robert J, Shanti, Putu A I, Kenangalem, Enny, Douglas, Nicholas M, Simpson, Julie A, Sugiarto, Paulus, Anstey, Nicholas M, and Price, Ric N
- Subjects
MALARIA prevention ,RISK of malaria ,CONFIDENCE intervals ,DIARRHEA ,HEALTH facilities ,HOSPITAL care ,HOSPITAL admission & discharge ,LONGITUDINAL method ,PATIENTS ,PUBLIC health ,SPLENECTOMY ,SURGERY ,MEDICAL records ,DISEASE eradication ,ODDS ratio - Abstract
Background Splenectomy increases the risk of severe and fatal infections; however, the risk of Plasmodium vivax malaria is unknown. We quantified the Plasmodium species-specific risks of malaria and other outcomes following splenectomy in patients attending a hospital in Papua, Indonesia. Methods Records of all patients attending Mitra-Masyarakat Hospital 2004–2013 were reviewed, identifying those who underwent splenectomy. Subsequent risks of specific clinical outcomes within 12 months for splenectomized patients were compared to nonsplenectomized patients from their first recorded hospital admission. In addition, patients splenectomized for trauma 2015–2016 were followed prospectively for 14 months. Results Of the 10774 patients hospitalized during 2004–2013, 67 underwent splenectomy. Compared to nonsplenectomized inpatients, patients undergoing splenectomy had a 5-fold higher rate of malaria presentation within 12 months (adjusted hazard ratio [AHR] = 5.0 [95% confidence interval (CI): 3.4–7.3], P <.001). The AHR was 7.8 (95% CI: 5.0–12.3) for P. vivax and 3.0 (95% CI: 1.7–5.4) for P. falciparum (both P <.001). Splenectomized patients had greater risk of being hospitalized for any cause (AHR = 1.8 [95% CI: 1.0–3.0], P =.037) and diarrheal (AHR = 3.5 [95% CI: 1.3–9.6], P =.016). In the 14-month prospective cohort, 12 episodes of P. vivax and 6 episodes of P. falciparum were observed in 11 splenectomised patients. Conclusions Splenectomy is associated with a high risk of malaria, greater for P. vivax than P. falciparum. Eradication of P. vivax hypnozoites using primaquine (radical cure) and subsequent malaria prophylaxis is warranted following splenectomy in malaria-endemic areas. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
19. Plasmodium malariae Infection Associated with a High Burden of Anemia: A Hospital-Based Surveillance Study
- Author
-
Langford, Siobhan, primary, Douglas, Nicholas M., additional, Lampah, Daniel A., additional, Simpson, Julie A., additional, Kenangalem, Enny, additional, Sugiarto, Paulus, additional, Anstey, Nicholas M., additional, Poespoprodjo, Jeanne Rini, additional, and Price, Ric N., additional
- Published
- 2015
- Full Text
- View/download PDF
20. Mortality attributable to Plasmodium vivaxmalaria: a clinical audit from Papua, Indonesia
- Author
-
Douglas, Nicholas M, primary, Pontororing, Gysje J, additional, Lampah, Daniel A, additional, Yeo, Tsin W, additional, Kenangalem, Enny, additional, Poespoprodjo, Jeanne Rini, additional, Ralph, Anna P, additional, Bangs, Michael J, additional, Sugiarto, Paulus, additional, Anstey, Nicholas M, additional, and Price, Ric N, additional
- Published
- 2014
- Full Text
- View/download PDF
21. Severe Vivax Malaria: Newly Recognised or Rediscovered?
- Author
-
Tjitra, Emiliana, Anstey, Nicholas M, Sugiarto, Paulus, Warikar, Noah, Kenangalem, Enny, Karyana, Muhammad, Lampah, Daniel A, and Price, Ric N
- Subjects
Adult ,Time Factors ,Plasmodium vivax ,Plasmodium falciparum ,lcsh:Medicine ,Plasmodium ,Severity of Illness Index ,Antimalarials ,Papua New Guinea ,Vivax infection ,parasitic diseases ,medicine ,Malaria, Vivax ,Animals ,Humans ,Clinical Trials ,Prospective Studies ,Tertian ,Malarial parasites ,Medicine(all) ,biology ,lcsh:R ,Infant ,General Medicine ,biology.organism_classification ,medicine.disease ,Prognosis ,Virology ,Malaria ,Infectious Diseases ,Child, Preschool ,Vivax malaria ,Immunology ,Preventive Medicine ,Research Article - Abstract
Background Multidrug-resistant Plasmodium vivax (Pv) is widespread in eastern Indonesia, and emerging elsewhere in Asia-Pacific and South America, but is generally regarded as a benign disease. The aim of the study was to review the spectrum of disease associated with malaria due to Pv and P. falciparum (Pf) in patients presenting to a hospital in Timika, southern Papua, Indonesia. Methods and Findings Data were prospectively collected from all patients attending the outpatient and inpatient departments of the only hospital in the region using systematic data forms and hospital computerised records. Between January 2004 and December 2007, clinical malaria was present in 16% (60,226/373,450) of hospital outpatients and 32% (12,171/37,800) of inpatients. Among patients admitted with slide-confirmed malaria, 64% of patients had Pf, 24% Pv, and 10.5% mixed infections. The proportion of malarial admissions attributable to Pv rose to 47% (415/887) in children under 1 y of age. Severe disease was present in 2,634 (22%) inpatients with malaria, with the risk greater among Pv (23% [675/2,937]) infections compared to Pf (20% [1,570/7,817]; odds ratio [OR] = 1.19 [95% confidence interval (CI) 1.08–1.32], p = 0.001), and greatest in patients with mixed infections (31% [389/1,273]); overall p < 0.0001. Severe anaemia (haemoglobin < 5 g/dl) was the major complication associated with Pv, accounting for 87% (589/675) of severe disease compared to 73% (1,144/1,570) of severe manifestations with Pf (p < 0.001). Pure Pv infection was also present in 78 patients with respiratory distress and 42 patients with coma. In total 242 (2.0%) patients with malaria died during admission: 2.2% (167/7,722) with Pf, 1.6% (46/2,916) with Pv, and 2.3% (29/1260) with mixed infections (p = 0.126). Conclusions In this region with established high-grade chloroquine resistance to both Pv and Pf, Pv is associated with severe and fatal malaria particularly in young children. The epidemiology of P. vivax needs to be re-examined elsewhere where chloroquine resistance is increasing., Ric Price and colleagues present data from southern Papua, Indonesia, suggesting that malaria resulting from infection withPlasmodium vivax is associated with substantial morbidity and mortality., Editors' Summary Background. Malaria, a parasitic disease transmitted to people by mosquitoes, is common throughout the tropical and subtropical areas of the world. In sub-Saharan Africa, infections with Plasmodium falciparum cause most of the malaria-associated illness and death. Elsewhere, another related parasite—P. vivax—is often the commonest cause of malaria. Both parasites are injected into the human blood stream when an infected mosquito bites a person. From there, the parasites travel to the liver, where they multiply for 8–9 d and mature into a form of the parasite known as merozoites. These merozoites are released from the liver and invade red blood cells where they multiply rapidly for a couple of days before bursting out and infecting more red blood cells. This cyclical accumulation of parasites in the blood causes a recurring flu-like illness characterized by fevers, headaches, chills, and sweating. Malaria can be treated with antimalarial drugs but, if left untreated, infections with P. falciparum can cause anemia (by destroying red blood cells) and can damage the brain and other vital organs (by blocking the capillaries that supply these organs with blood), complications that can be fatal. Why Was This Study Done? Unlike falciparum malaria, vivax malaria is generally regarded as a benign or nonfatal disease even though there have been several reports recently of severe disease and deaths associated with vivax malaria. These reports do not indicate, however, whether P. vivax is responsible for a significant proportion of malarial deaths. Public health officials need to know this information because strains of P. vivax that are resistant to multiple antimalarial drugs are widespread in Indonesia and beginning to emerge elsewhere in Asia and South America. In this study, therefore, the researchers investigate the relative burden of vivax and falciparum malaria in Papua, Indonesia, a region where multidrug-resistant strains of both P. falciparum and P. vivax are common. What Did the Researchers Do and Find? The researchers examined data collected from all the patients attending the outpatient and inpatient departments of a hospital that serves a large area in the southern lowlands of Papua, Indonesia between January 2004 and December 2007. Among those inpatients in whom malaria had been confirmed by finding parasites in blood samples, two-thirds were infected with P. falciparum, a quarter with P. vivax, and the rest with a mixture of parasites. Nearly one in four patients infected with P. vivax developed severe malaria compared with roughly one in five patients infected with P. falciparum. However, about one in three patients infected with both parasites developed severe disease. Whichever parasite was responsible for the infection, the proportion of patients with severe disease was greatest among children below the age of five years. Severe anemia was the commonest complication associated with severe malaria caused by both P. vivax and P. falciparum (present in 87% and 73% of cases, respectively). Finally, one in 50 patients with malaria died; the risk of death was the same for patients infected with P. falciparum, P. vivax, or both parasites. What Do These Findings Mean? These findings provide important information about the burden of malaria associated with P. vivax infection. They show that in a region where multidrug-resistant strains of both P. falciparum and P. vivax are common, P. vivax infection (as well as P. falciparum infection) is associated with severe and fatal malaria, particularly in young children. The findings also show that infection with a mixture of the two parasites is associated with a higher risk of severe disease than infection with either parasite alone. Most importantly, they show that similar proportions of patients infected with P. falciparum, P. vivax, or a mixture of parasites die. Further studies need to be done in other settings to confirm these findings and to learn more about the pattern of severe malaria associated with P. vivax (in particular, with multidrug-resistant strains). Nevertheless, these findings highlight the need to consider both P. vivax and P. falciparum when implementing measures designed to reduce the malaria burden in regions where these parasites coexist. Additional Information. Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0050128. A PLoS Medicine Research in Translation article by Stephen Rogerson further discusses this study and a related PLoS Medicine paper on vivax malaria in a community cohort from Papua New Guinea The MedlinePlus encyclopedia has a page on malaria (in English and Spanish) The US Centers for Disease Control and Prevention provides information on malaria (in English and Spanish) Vivaxmalaria provides information on topics related to P. vivax The Malaria Vaccine Initiative also provides a fact sheet on P. vivax malaria Information is available from the Roll Back Malaria Partnership on the global control of malaria
- Published
- 2008
22. Severe Malarial Thrombocytopenia: A Risk Factor for Mortality in Papua, Indonesia
- Author
-
Lampah, Daniel A., primary, Yeo, Tsin W., additional, Malloy, Michael, additional, Kenangalem, Enny, additional, Douglas, Nicholas M., additional, Ronaldo, Donny, additional, Sugiarto, Paulus, additional, Simpson, Julie A., additional, Poespoprodjo, Jeanne Rini, additional, Anstey, Nicholas M., additional, and Price, Ric N., additional
- Published
- 2014
- Full Text
- View/download PDF
23. Dihydroartemisinin-Piperaquine Treatment of Multidrug Resistant Falciparum and Vivax Malaria in Pregnancy
- Author
-
Poespoprodjo, Jeanne Rini, primary, Fobia, Wendy, additional, Kenangalem, Enny, additional, Lampah, Daniel A., additional, Sugiarto, Paulus, additional, Tjitra, Emiliana, additional, Anstey, Nicholas M., additional, and Price, Ric N., additional
- Published
- 2014
- Full Text
- View/download PDF
24. Coma Associated with Microscopy-Diagnosed Plasmodium vivax: A Prospective Study in Papua, Indonesia
- Author
-
Lampah, Daniel A., primary, Yeo, Tsin W., additional, Hardianto, Setiawan O., additional, Tjitra, Emiliana, additional, Kenangalem, Enny, additional, Sugiarto, Paulus, additional, Price, Ric N., additional, and Anstey, Nicholas M., additional
- Published
- 2011
- Full Text
- View/download PDF
25. Severe Congenital Malaria Acquired in utero
- Author
-
Poespoprodjo, Jeanne R., primary, Anstey, Nicholas M., additional, Hasanuddin, Afdal, additional, Sugiarto, Paulus, additional, Lampah, Daniel A., additional, Price, Ric N., additional, Fobia, Wendelina, additional, Kenangalem, Enny, additional, and Tjitra, Emiliana, additional
- Published
- 2010
- Full Text
- View/download PDF
26. Malaria morbidity in Papua Indonesia, an area with multidrug resistant Plasmodium vivax and Plasmodium falciparum
- Author
-
Karyana, Muhammad, primary, Burdarm, Lenny, additional, Yeung, Shunmay, additional, Kenangalem, Enny, additional, Wariker, Noah, additional, Maristela, Rilia, additional, Umana, Ketut Gde, additional, Vemuri, Ram, additional, Okoseray, Maurits J, additional, Penttinen, Pasi M, additional, Ebsworth, Peter, additional, Sugiarto, Paulus, additional, Anstey, Nicholas M, additional, Tjitra, Emiliana, additional, and Price, Richard N, additional
- Published
- 2008
- Full Text
- View/download PDF
27. Adverse Pregnancy Outcomes in an Area Where Multidrug‐ResistantPlasmodium vivaxandPlasmodium falciparumInfections Are Endemic
- Author
-
Poespoprodjo, Jeanne Rini, primary, Fobia, Wendy, additional, Kenangalem, Enny, additional, Lampah, Daniel A., additional, Warikar, Noah, additional, Seal, Andrew, additional, McGready, Rose, additional, Sugiarto, Paulus, additional, Tjitra, Emiliana, additional, Anstey, Nicholas M., additional, and Price, Ric N., additional
- Published
- 2008
- Full Text
- View/download PDF
28. Mortality attributable to Plasmodium vivax malaria: a clinical audit from Papua, Indonesia.
- Author
-
Douglas, Nicholas M, Pontororing, Gysje J, Lampah, Daniel A, Tsin W Yeo, Kenangalem, Enny, Poespoprodjo, Jeanne Rini, Ralph, Anna P, Bangs, Michael J, Sugiarto, Paulus, Anstey, Nicholas M, and Price, Ric N
- Abstract
Background: Plasmodium vivax causes almost half of all malaria cases in Asia and is recognised as a significant cause of morbidity. In recent years it has been associated with severe and fatal disease. The extent to which P. vivax contributes to death is not known. Methods: To define the epidemiology of mortality attributable to vivax malaria in southern Papua, Indonesia, a retrospective clinical records-based audit was conducted of all deaths in patients with vivax malaria at a tertiary referral hospital. Results: Between January 2004 and September 2009, hospital surveillance identified 3,495 inpatients with P. vivax monoinfection and 65 (1.9%) patients who subsequently died. Charts for 54 of these 65 patients could be reviewed, 40 (74%) of whom had pure P. vivax infections on cross-checking. Using pre-defined conservative criteria, vivax malaria was the primary cause of death in 6 cases, a major contributor in 17 cases and a minor contributor in a further 13 cases. Extreme anaemia was the most common primary cause of death. Malnutrition, sepsis with respiratory and gastrointestinal manifestations, and chronic diseases were the commonest attributed causes of death for patients in the latter two categories. There were an estimated 293,763 cases of pure P. vivax infection in the community during the study period giving an overall minimum case fatality of 0.12 per 1,000 infections. The corresponding case fatality in hospitalised patients was 10.3 per 1,000 infections. Conclusions: Although uncommonly directly fatal, vivax malaria is an important indirect cause of death in southern Papua in patients with malnutrition, sepsis syndrome and chronic diseases, including HIV infection. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
29. 787Multistate modelling to investigate the impact of recurrent malaria episodes on hospital admissions and mortality.
- Author
-
Dini, Saber, Douglas, Nicholas, Poespoprodjo, Jeanne Rini, Kenangalem, Enny, Sugiarto, Paulus, Plumb, Ian, Price, Ric, and Simpson, Julie
- Subjects
HOSPITAL admission & discharge ,MALARIA ,HOSPITAL mortality ,MALARIA prevention ,EARLY death ,RATINGS of hospitals ,DEATH rate - Abstract
Background Inadequate prevention and treatment of malaria can lead to reinfections and recurrent episodes, and for vivax malaria, further recurrences from the dormant liver stage. This study quantified the impact of recurrent malaria episodes on morbidity and mortality. Methods Routinely collected data were available from 68,381 malaria patients presenting to the primary referral hospital in Papua, Indonesia. A multi-state modelling framework, with Cox regression for transition rates, was employed to determine the risks of re-presentation to hospital, receiving in-patient treatment, and early (≤14 days post treatment)/late death following multiple malaria episodes. Results The risk of re-presentation to hospital increased from 34.7% (95%CI: 34.4%–35.1%) at first episode to 58.6% (57.5%–59.6%) following the third episode. Infection with vivax malaria increased the rate of re-presentation to hospital by 1.48-fold (Hazard Ratio 1.48; 95%CI 1.44–1.51) and late hospital in-patient admission by 1.17-fold (1.11–1.22), compared to falciparum. Falciparum malaria caused a higher overall rate of early death (1.54 (1.25–1.92)), however, after multiple episodes, there was a trend towards a greater rate of early death for vivax infection (1.91 (0.73–4.97)). Conclusions Recurrent episodes of malaria can cause substantial morbidity and mortality, highlighting the importance of prevention and effective treatments for both falciparum and vivax malaria. Key messages To achieve elimination of malaria in South-East Asia, where prevalence of vivax malaria is high, we must prioritise the radical cure of vivax to eliminate the liver-stage of this species that causes relapses of infection. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
30. Additional file 1 of The risk of morbidity and mortality following recurrent malaria in Papua, Indonesia: a retrospective cohort study
- Author
-
Dini, Saber, Douglas, Nicholas, Poespoprodjo, Jeanne, Kenangalem, Enny, Sugiarto, Paulus, Plumb, Ian, Ric Price, and Simpson, Julie
- Subjects
3. Good health - Abstract
The file contains details of the developed multi-state model and some additional statistical analyses under the following sections: A. Multi-state modelling of malaria recurrence; B. Episode-specific effects of risk factors; C. Results of univariable analysis; D. Effect modification of species on the rate of events by patients’ age; E. Effect of severity of the initial episode on mortality; F. Re-admission and death multi-state model.
31. Additional file 1 of The risk of morbidity and mortality following recurrent malaria in Papua, Indonesia: a retrospective cohort study
- Author
-
Dini, Saber, Douglas, Nicholas, Poespoprodjo, Jeanne, Kenangalem, Enny, Sugiarto, Paulus, Plumb, Ian, Ric Price, and Simpson, Julie
- Subjects
3. Good health - Abstract
The file contains details of the developed multi-state model and some additional statistical analyses under the following sections: A. Multi-state modelling of malaria recurrence; B. Episode-specific effects of risk factors; C. Results of univariable analysis; D. Effect modification of species on the rate of events by patients’ age; E. Effect of severity of the initial episode on mortality; F. Re-admission and death multi-state model.
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.