RESUMO
OBJECTIVES: This retrospective analysis performed in Manhiça, Southern Mozambique, aimed to describe the frequency of post-malarial anemia (measured as a decrease of hematocrit ≥10%) and the need for blood transfusions in children with severe malaria treated with intravenous quinine or parenteral artesunate. METHODS: All children <15 years admitted with a parasitologically-confirmed diagnosis of malaria from 1st January 2003 to 31st December 2017, alive at hospital discharge, and with at least one measurement of hematocrit within 28 days after hospital discharge, detected by passive case detection, were included. RESULTS: The overall prevalence of post-malarial anemia observed in the study was 23.13%, with an estimated incidence rate of 288.84 episodes/1,000 children-month at risk in the follow-up period (28 days after discharge). There were no differences between treatment groups, although the study showed a higher association between blood transfusions and artesunate treatment. CONCLUSIONS: In this setting, children with severe malaria frequently present a meaningful decrease of hematocrit (>=10%) in the first weeks after their episode, sometimes requiring blood transfusions. Because of the high underlying prevalence of anemia in malaria-endemic settings, all children with severe malaria need to be actively followed up, irrespective of the treatment received.
Assuntos
Anemia/etiologia , Antimaláricos/administração & dosagem , Artesunato/administração & dosagem , Malária/complicações , Malária/tratamento farmacológico , Quinina/administração & dosagem , Administração Intravenosa , Adolescente , Anemia/epidemiologia , Antimaláricos/efeitos adversos , Artesunato/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Moçambique/epidemiologia , Quinina/efeitos adversos , Estudos RetrospectivosRESUMO
We report a case of Sneathia amnii as the causative agent of maternal chorioamnionitis and congenital pneumonia resulting in a late fetal death in Mozambique, with strong supportive postmortem molecular and histopathologic confirmation. This rare, fastidious gram-negative coccobacillus has been reported to infrequently cause abortions, stillbirths, and neonatal infections.
Assuntos
Corioamnionite/diagnóstico , Corioamnionite/microbiologia , Infecções por Fusobacteriaceae/diagnóstico , Infecções por Fusobacteriaceae/microbiologia , Leptotrichia , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/microbiologia , Natimorto , Adulto , Autopsia , Corioamnionite/epidemiologia , Feminino , Infecções por Fusobacteriaceae/epidemiologia , Humanos , Imuno-Histoquímica , Pulmão/microbiologia , Pulmão/patologia , Moçambique/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologiaRESUMO
Influenza is often misdiagnosed in children because of the low sensitivity of clinical diagnosis because of nonspecific signs and symptoms. This can be overcome by using digital immunoassays or rapid molecular diagnostic tests with adequate sensitivity and specificity. When using these tests at the patient care site, antibiotic consumption and number of healthcare consultations were reduced.