Describe and then critically analyze a recently published pathophysiology research - Article Example

There are two main species of malaria worldwide which cause the majority of cases. Plasmodium vivax has been considered for a long time as a benign and self-limited species, while Plasmodium falciparum is the species known to cause serious disease and death. Plasmodium vivax accounts for the majority of malaria cases in the Brazilian Amazon region. Recently there have been reports that malaria caused by P. vivax may be as severe as P. falciparum. The complications of P. vivax infection represent a significant global health menace, which needs focused efforts to work for its resolution.

In severe falciparum malaria, as in many other systemic infections, most of the pathology that is described seems to be a consequence of an intense inflammatory response, produced by a pathological over-activation of the immune system and excessive cytokine release. However, there have been no previous studies on the inflammatory and immunological status of both mild and severe vivax malaria disease. In order to understand the immunopathological events in vivax malaria, and to differentiate its pathophysiology from P.

falciparum, it is important to explore the pattern of cytokines released in patients suffering from P. vivax malaria. Discussion The purpose of the study by Andrade et al. was to investigate the inflammatory and immunological status of both mild and severe vivax malaria cases, and compare them, in order to understand the immunopathological events in malaria by Plasmodium vivax infection. The researchers conducted the study in south-western part of Brazilian Amazon, which has an unstable transmission of malaria.

They determined the active and passive cases of malaria, in both healthy people and those visiting the hospital. They included in their study patients with malaria admitted at the Buritis Municipal Hospital, and approached individuals, aged 15 – 70 years, with home visits, who lived in high malaria transmission areas. They took an interview from the participants who agreed to be a part of the study with questions about the symptoms of malaria – fever, chills, jaundice, etc. They also took venous blood samples from the participants for investigations.

These investigations included peripheral blood smear and PCR for malaria diagnosis, and inflammatory markers’ blood levels: plasma cytokines IL-10, interferon-gamma (IFN-gamma), and tumor necrosis factor (TNF). They also measured ALT, creatinine, and C reactive protein (CRP) levels in the blood. They then analyzed the data and used chi-square test and Spearman’s correlation to compare the inflammatory markers’ levels between patients with severe malaria, non-severe malaria, and asymptomatic infection with P. vivax. They reported from their results that patients with severe P.

vivax infection were younger, had lived for a shorter period of time in the endemic area of malaria, and had experienced less previous malaria episodes than individuals with no malaria infection or asymptomatic infection. Strong linear trends were found to associate inflammatory markers with severe disease. Increasing plasma levels of CRP, serum creatinine, bilirubin, TNF and IFN-gamma were associated with increasing disease severity. These laboratory parameters of organ dysfunction and inflammatory cytokines started to decrease in the patients with