Severe Vivax Malaria Newly Recognised or Rediscovered 英文参考文献.docVIP

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Severe Vivax Malaria Newly Recognised or Rediscovered 英文参考文献.doc

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Severe Vivax Malaria Newly Recognised or Rediscovered 英文参考文献

Research in Translation Severe Vivax Malaria: Newly Recognised or Rediscovered? Stephen J. Rogerson , Richard Carter * M alignant tertian” and “benign tertian” are terms that have long been used for two of the Linked Research Articles and 40% of severe cases of vivax and falciparum, respectively. Neurologic symptoms were present in 25% of severe cases of either species. This Research in Translation discusses the following new studies published in PLoS Medicine: Genton B, D’Acremont V, Rare L, Baea K, Reeder JC, et al. (2008) Plasmodium vivax and mixed infections are associated with severe malaria in children: A prospective cohort study from Papua New Guinea. PLoS Med 5(6): e127. doi:10.1371/journal. pmed.0050127 major diseases we recognise as malaria. The former is generally considered to be synonymous with Plasmodium falciparum and the latter with P. vivax infection. As the names “malignant” and “benign” suggest, the current dogma is that P. falciparum can be severe and life-threatening while P. vivax tends to be mild. However, two studies published in this issue of PLoS Medicine challenge this dogma. The cases of cerebral malaria due to P. vivax reported in both studies, occurring in all age groups, are intriguing, because this malaria complication has rarely been reported previously in association with P. vivax infection. In P. falciparum, cerebral malaria is primarily attributed to sequestration of infected erythrocytes in cerebral vessels. As P. vivax does not sequester, coma must arise by other means—perhaps of systemic metabolic origin—in vivax malaria. This aetiology may also underlie some cerebral malaria presentations in children. Both studies, inevitably, have limitations. First, co-morbidities, including concomitant bacterial or viral infections, which could have decreased the malaria-attributable fraction of disease [3], were not actively investigated. Second, microscopy was used for parasite detection and speciation, which routinely leads to In a