RESUMO
INTRODUCTION: The Integrated Program of Leprosy Control was initiated in 2003 in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy. Here, we present the evolution of the indicators of leprosy within the established period in children aged <15 years. METHODS: This is a descriptive study based on an active search for cases and spontaneous healthcare demand for leprosy, with an evolutionary analysis of the detection coefficient of new cases. We considered individuals aged <15 years diagnosed with leprosy from January 2003 to December 2015. To evaluate the factors associated with clinical and operational forms, Chi-square, Fisher's exact, or Fisher-Freeman-Halton tests were performed. RESULTS: A total of 61 new cases were detected (6.9% of the total leprosy cases diagnosed in the municipality during the study period), and the majority was found in males (62.3%). The most frequent operational classification was paucibacillary (67.2%), and this association increased with age. The tuberculoid clinical form was the most prevalent in both sexes and in the age range of 10 to <15 years. There was a reduction in the detection coefficient from 21.84/100,000 inhabitants in 2003 to 2.79/100,000 in 2015. CONCLUSIONS: Despite the progress in the control of leprosy, this historical series shows that it is necessary to strengthen educational measures and implement control actions, so that the disease ceases to be a public health problem in the population aged <15 years.
Assuntos
Doenças Endêmicas , Hanseníase , Adolescente , Brasil/epidemiologia , Criança , Escolaridade , Feminino , Humanos , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Masculino , Saúde PúblicaRESUMO
INTRODUCTION: The Integrated Program of Leprosy Control was initiated in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy in 2003. It aims at assessing the clinical and epidemiological characteristics of the disease to reduce the detection rate of new cases until 2015. Here, we present the evolution of the indicators of leprosy within the period from 2003 to 2015. METHODS: We conducted a descriptive analytical study based on the active search for and voluntary referral of cases of leprosy. The detection rate of new cases was analyzed over time. We included individuals diagnosed with leprosy between January 2003 and December 2015. The association between categorical variables was assessed using the chi-square test of independence, considering a level of significance of 5%. When the association was significant, the detection rate (with a confidence interval of 95%) was calculated. RESULTS: Overall, 879 new leprosy cases were detected; the majority of the affected individuals were men (65.9%). Multibacillary leprosy was the most common type of the disease, according to the operational classification (55.5%); it showed the strongest association with an age ≥60 years. We also detected an association between the male sex and both, lepromatous and multibacillary leprosy. The detection rate reduced from 211.09/100,000 population in 2003 to 50.26/100,000 population in 2015. CONCLUSIONS: We found an improvement in leprosy control, with a reduction in the detection rate and the absolute number of cases. Strengthening of disease control measures should be prioritized to eliminate leprosy as a public health concern in this municipality.
Assuntos
Hanseníase Multibacilar/epidemiologia , Hanseníase Paucibacilar/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Educação em Saúde , Humanos , Incidência , Hanseníase Multibacilar/prevenção & controle , Hanseníase Paucibacilar/prevenção & controle , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Adulto JovemRESUMO
This study had the aim of determining the coefficient of leprosy detection among the student population of the municipality of Buriticupu, State of Maranhão. An active case search method was used, covering a population of 14,653 students, in 53 schools within the municipal network. Clinical examination gave rise to a leprosy diagnosis for 20 students, which represents a detection coefficient of 13.6/10,000 students. Cutaneous lymph bacilloscopy was performed on all cases, and it was positive in two samples. The predominant clinical form was the indeterminate form, with 12 cases (60%), followed by the tuberculoid form, with five (25%) and the dimorphous form with two (10%). Biopsies were then taken from the lesions of 11 patients, and histopathological analysis showed common findings of hyperkeratosis, mononuclear inflammatory infiltrate and ectasia of vessels and isolated arrector pili muscles. The study also enabled identification of some other infectious skin diseases: pityriasis versicolor in 793, scabies in 361 and dermatophytosis in 119. A variety of nonspecific conditions were also detected, such as scars, nevi and excoriation, in 1,020 students.
Assuntos
Hanseníase/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Criança , Feminino , Humanos , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , MasculinoRESUMO
The study was developed in the neighborhood of Residencial Paraíso, São Luis, Maranhão, Brazil, from 1999 to 2001. The aim was to analyze the epidemiological aspects of malaria. The location is receptive and vulnerable to malaria. There were 129 cases. Men from 20 to 29 years of age were most involved. Plasmodium vivax was the agent of all cases and Anopheles aquasalis was the vector. There was no evidence of transmission occurring outside of the houses.
Assuntos
Anopheles , Insetos Vetores , Malária Vivax/epidemiologia , Plasmodium vivax , Adolescente , Adulto , Distribuição por Idade , Animais , Antimaláricos/uso terapêutico , Brasil/epidemiologia , Criança , Pré-Escolar , Cloroquina/uso terapêutico , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Malária Vivax/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estações do AnoRESUMO
Abstract INTRODUCTION The Integrated Program of Leprosy Control was initiated in 2003 in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy. Here, we present the evolution of the indicators of leprosy within the established period in children aged <15 years. METHODS: This is a descriptive study based on an active search for cases and spontaneous healthcare demand for leprosy, with an evolutionary analysis of the detection coefficient of new cases. We considered individuals aged <15 years diagnosed with leprosy from January 2003 to December 2015. To evaluate the factors associated with clinical and operational forms, Chi-square, Fisher's exact, or Fisher-Freeman-Halton tests were performed. RESULTS A total of 61 new cases were detected (6.9% of the total leprosy cases diagnosed in the municipality during the study period), and the majority was found in males (62.3%). The most frequent operational classification was paucibacillary (67.2%), and this association increased with age. The tuberculoid clinical form was the most prevalent in both sexes and in the age range of 10 to <15 years. There was a reduction in the detection coefficient from 21.84/100,000 inhabitants in 2003 to 2.79/100,000 in 2015. CONCLUSIONS Despite the progress in the control of leprosy, this historical series shows that it is necessary to strengthen educational measures and implement control actions, so that the disease ceases to be a public health problem in the population aged <15 years.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doenças Endêmicas , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Brasil/epidemiologia , Saúde Pública , EscolaridadeRESUMO
The space occupation and the expansion of American visceral leishmaniasis (AVL) were described in the municipality of São Luis, Maranhão, Northeast Brazil. AVL medical notes from the Fundação Nacional de Saúde as well as official documents about the space occupation were analyzed from September 1982 to December 1996. AVL cases were more likely to occur in recently settled suburbs and tended to follow the same spatial pattern observed for land occupations secondary to migratory fluxes.
Assuntos
Leishmaniose Visceral/epidemiologia , Brasil/epidemiologia , HumanosRESUMO
INTRODUCTION: Malaria caused by Plasmodium vivax species has shown signs of severity, recorded with increasing frequency in the medical literature. This study aimed to characterize the signs of severe malaria by Plasmodium vivax in the State of Maranhão, Brazil. METHODS: A descriptive cohort study of patients assisted in the field and a historical and concurrent study of a series of cases among hospitalized patients were undertaken to identify the clinical and laboratory signs of severity. RESULTS: A total of 153 patients were included in the study, 13 of whom were hospitalized. Males made up the majority, numbering 103 (67.3%). The age of the patients ranged from 10 to 70 years, 92.2% were natives of the State of Maranhão, and 65% of the patients had had malaria before. The average time elapsed between symptom onset and diagnosis among outpatients was three days, while among hospitalized patients this average reached 15.5 days, a statistically significant difference (p=0.001). The parasitemia ranged from 500 to 10,000 parasites/µl in 92.8% of cases. The clinical and laboratory manifestations of severity were vomiting and diarrhea, jaundice, drowsiness, mental confusion, seizures, loss of consciousness, agitation, bleeding, pale skin, coughing and dyspnea, thrombocytopenia, anemia, elevation of nitrogenous compounds, and elevated transaminases and bilirubin. CONCLUSIONS: The monitoring of malaria patients with Plasmodium vivax showed the possibility of aggravation, the intensity of which varied in different circumstances, especially the interval time between falling ill and diagnostic confirmation.
Assuntos
Malária Vivax/complicações , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Feminino , Humanos , Malária Vivax/epidemiologia , Masculino , Pessoa de Meia-Idade , Parasitemia/parasitologia , Fatores de Risco , Adulto JovemRESUMO
INTRODUCTION: The relationship between severe clinical manifestations of visceral leishmaniasis (VL) and immune response profiles has not yet been clarified, despite numerous studies on the subject. This study aimed to investigate the relationship between cytokine profiles and the presence of immunological markers associated with clinical manifestations and, particularly, signs of severity, as defined in a protocol drafted by the Ministry of Health (Brazil). METHODS: We conducted a prospective, descriptive study between May 2008 and December 2009. This study was based on an assessment of all pediatric patients with VL who were observed in a reference hospital in Maranhão. RESULTS: Among 27 children, 55.5% presented with more than one sign of severity or warning sign. Patients without signs of severity or warning signs and patients with only one warning sign had the highest interferon-gamma (IFN-γ) levels, although their interleukin 10 (IL-10) levels were also elevated. In contrast, patients with the features of severe disease had the lowest IFN-γ levels. Three patients who presented with more than two signs of severe disease died; these patients had undetectable interleukin 2 (IL-2) and IFN-γ levels and low IL-10 levels, which varied between 0 and 36.8pg/mL. CONCLUSIONS: Our results showed that disease severity was associated with low IFN-γ levels and elevated IL-10 levels. However, further studies with larger samples are needed to better characterize the relationship between disease severity and cytokine levels, with the aim of identifying immunological markers of active-disease severity.
Assuntos
Interferon gama/sangue , Interleucina-10/sangue , Interleucina-2/sangue , Leishmaniose Visceral/imunologia , Biomarcadores/sangue , Criança , Pré-Escolar , Feminino , Humanos , Leishmaniose Visceral/sangue , Masculino , Estudos Prospectivos , Índice de Gravidade de DoençaRESUMO
Abstract INTRODUCTION: The Integrated Program of Leprosy Control was initiated in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy in 2003. It aims at assessing the clinical and epidemiological characteristics of the disease to reduce the detection rate of new cases until 2015. Here, we present the evolution of the indicators of leprosy within the period from 2003 to 2015. METHODS: We conducted a descriptive analytical study based on the active search for and voluntary referral of cases of leprosy. The detection rate of new cases was analyzed over time. We included individuals diagnosed with leprosy between January 2003 and December 2015. The association between categorical variables was assessed using the chi-square test of independence, considering a level of significance of 5%. When the association was significant, the detection rate (with a confidence interval of 95%) was calculated. RESULTS: Overall, 879 new leprosy cases were detected; the majority of the affected individuals were men (65.9%). Multibacillary leprosy was the most common type of the disease, according to the operational classification (55.5%); it showed the strongest association with an age ≥60 years. We also detected an association between the male sex and both, lepromatous and multibacillary leprosy. The detection rate reduced from 211.09/100,000 population in 2003 to 50.26/100,000 population in 2015. CONCLUSIONS: We found an improvement in leprosy control, with a reduction in the detection rate and the absolute number of cases. Strengthening of disease control measures should be prioritized to eliminate leprosy as a public health concern in this municipality.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Hanseníase Multibacilar/epidemiologia , Hanseníase Paucibacilar/epidemiologia , Brasil/epidemiologia , Educação em Saúde , Incidência , Hanseníase Multibacilar/prevenção & controle , Hanseníase Paucibacilar/prevenção & controle , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: The study aimed to show the situation of paracoccidioidomycosis in the state of Maranhão, Brazil. METHODS: This study is a descriptive case series developed in two stages. First, a survey of cases originating from the state of Maranhão at the Instituto de Doenças Tropicais Natan Portela, Piauí (IDTNP) from 1997 to 2007, and second, the clinical description of 29 cases diagnosed in the Centro de Referências em Doenças Infecciosas e Parasitárias, Maranhão (CREDIP) from 2004 to 2010. RESULTS: Two hundred and sixteen cases have been cataloged at the IDTNP. West, east, and central regions of the state of Maranhão recorded 90.3% of cases proving to be important areas for study. The western region, with a prevalence of 10.8/100,000 inhabitants, has a significantly higher proportion of cases than the northern, southern, and eastern regions (p < 0.05). The occurrence was higher in men with 89.3% of cases, and the male-to-female ratio was 8.4:1. The majority of patients were older than 20 years, lived in rural areas, and had farming or soil management as main occupation (73.8%). At CREDIP, 29 cases were diagnosed, of which 26 (89.6%) had multifocal manifestations. Mucous tissues were involved more (75.8%) frequently, followed by lymph nodes, skin, and lungs with 65.5%, 39% and 37.9 %, respectively. The diagnosis was made by combining direct examination, culture, and histopathology. CONCLUSIONS: The study shows the geographical distribution and the epidemiological and clinical aspects of paracoccidioidomycosis, revealing the significance of the disease to the state of Maranhão.
Assuntos
Paracoccidioidomicose/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Geografia Médica , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural , Adulto JovemRESUMO
INTRODUCTION: This study was developed to evaluate the situation of leprosy in the general population of the municipality of Buriticupu, State of Maranhão, Brazil. METHODS: We used the method of active search to identify new cases from 2008 to 2010. Bacilloscopy of intradermal scrapings was performed in all patients with skin lesions compatible with leprosy, and histopathological examination in those who had doubts on the definition of the clinical form. RESULTS: The study included 19,104 individuals, with 42 patients diagnosed with leprosy after clinical examination, representing a detection rate of 219.84 per 100,000 inhabitants. The predominant clinical presentation was tuberculoid with 24 (57.1%) cases, followed by borderline with 11, indeterminate with four, and lepromatous with three cases. The study also allowed the identification of 81 patients with a history of leprosy and other skin diseases, such as pityriasis versicolor, dermatophytosis, scabies, vitiligo, and skin carcinoma. The binomial test showed that the proportion of cases in the headquarters was significantly higher than that in the villages (p = 0.04), and the generalized exact test showed that there was no association between age and clinical form (p = 0.438) and between age and gender (p = 0.083). CONCLUSIONS: The elevated detection rate defines the city as hyperendemic for leprosy; the active search for cases, as well as the organization of health services, is an important method for disease control.
Assuntos
Doenças Endêmicas , Hanseníase/epidemiologia , Adulto , Brasil/epidemiologia , Feminino , Humanos , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
O estudo foi desenvolvido com o objetivo de avaliar a evolução da malária no estado do Maranhão no período de 2009 a 2013. Números absolutos de casos e incidência parasitária anual (IPA) das cinco regiões geográficas do estado, nas 19 Unidades Regionais de Saúde (URS) e nos 10 municípios com maior registro da doença, foram avaliados com base nos registros do Departamento de Endemias da Secretaria de Estado da Saúde. Foram notificados 16.847 casos no período do estudo. No ano de 2009, a Incidência Parasitária Anual era de 0,86/1.000 habitantes, já em 2013 este indicador chegou a 0,08/1.000 habitantes no estado, o que corresponde a um percentual de redução de 90,6%. Houve aumento moderado do número de casos na região norte no ano de 2011 e na região centro nos anos de 2010 e 2011. No ano de 2010, verificou-se aumento desses valores em sete unidades regionais de saúde; em 2011, em seis e, em 2012, em duas. No ano de 2013, houve maior registro de casos, em relação a 2012, na unidade regional de Codó. Entre os municípios que registraram a doença, destacam-se Centro Novo do Maranhão, Cândido Mendes, Alcântara, Amapá do Maranhão, Presidente Sarney e Guimarães, os quais apresentaram indicador de médio risco em diferentes momentos no período de estudo. Houve redução da incidência de casos, com a incidência parasitária anual menor que 10 casos /1.000 habitantes (baixo risco), no ano de 2013, em todas as áreas estudadas.
Assuntos
Malária , Ecossistema AmazônicoRESUMO
INTRODUCTION: Chagas' disease is not considered an endemic disease in the State of Maranhão. However, entomological surveys showed high natural vector infection indices and acute cases have been identified in the last few decades. This study aimed to analyze the social, demographic and environmental conditions involved in transmission. METHODS: The study describes acute Chagas' disease identified from 1994 to 2008. Information regarding the cases was obtained from the Information System for Notifiable Diseases (Sinan), National Health Foundation (Funasa) database and medical records. Entomological surveys were conducted from 2002. RESULTS: Data analysis identified 32 cases from 17 municipal districts, with 84.4% of patients from rural areas. The disease was more frequent in men (67%). The most frequent occupation was student, 38.9% of cases, followed by farmer and hunter, 27.8%. CONCLUSIONS: The study suggests that transmission was vectorial and occurred in the wild or peridomicile.
Assuntos
Doença de Chagas/epidemiologia , Insetos Vetores , Rhodnius , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil/epidemiologia , Doença de Chagas/transmissão , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , População Rural , Fatores Socioeconômicos , População Urbana , Adulto JovemRESUMO
INTRODUCTION: This study aimed to analyze the leprosy situation, focusing on the adult population of the town of Buriticupu, State of Maranhão. METHODS: An active search was conducted to identify new cases from 2005 to 2007. All patients with injuries suggestive of leprosy were submitted to cutaneous bacilloscopy and biopsies were performed when defining the clinical presentation was difficulty. RESULTS: 15,409 individuals participated in the study and 62 were diagnosed with leprosy which represents a detection coefficient of 40.23/10,000. Bacilloscopy showed positive results in six patients. The predominant clinical form was tuberculoid, 31 cases, followed by the indeterminate form (20 cases), the dimorphous form (10 cases) and the lepromatous form (1 case). The study also identified other skin diseases, including pityriasis versicolor, scabies, mycosis, vitiligo and carcinoma. CONCLUSIONS: The high detection coefficient defines the town of Buriticupu, MA, as hyperendemic for leprosy. Active cases search is an important method for disease control.
Assuntos
Doenças Endêmicas , Hanseníase/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Feminino , Humanos , Hanseníase/classificação , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
This study aimed to show the results from malaria control in the State of Maranhão, based on the state's control plans and on the historical series of malaria records over the period from 1999 to 2007. The evolution of malaria cases was analyzed by comparing the annual incidences of parasitism (total number of cases notified per 1,000 inhabitants) according to geographical area, regional healthcare units and the 46 municipalities included in the plans. Analysis of the results allowed the conclusion that the plans were effective, since the annual incidence went down from 10.1 cases to 1.1 cases per 1,000 inhabitants, i.e. a regression of 89.1%, the largest among all the states in the Amazon region.
Assuntos
Malária/prevenção & controle , Programas Nacionais de Saúde , Brasil/epidemiologia , Humanos , Incidência , Malária/epidemiologiaRESUMO
This study was developed with the aim of characterizing Plasmodium vivax circumsporozoite protein genotypes on the Island of São Luís, Maranhão. Blood samples were taken for direct parasitological examination (thick blood film) from 126 individuals. Among these individuals, 109 samples were also taken for molecular diagnosis by means of the polymerase chain reaction. The parasitological examination showed the presence of Plasmodium vivax in two symptomatic individuals, while the molecular study was positive for Plasmodium vivax in seven individuals (two symptomatic and positive from the thick blood film and five asymptomatic and negative from the thick blood film). Two samples showed an association with Plasmodium falciparum. Genotyping of the Plasmodium vivax samples showed that the VK 210 variant was present. This was associated with the VK 247 variant in two samples.
Assuntos
Malária Vivax/parasitologia , Plasmodium vivax/genética , Proteínas de Protozoários/genética , Adolescente , Animais , Criança , Pré-Escolar , DNA de Protozoário/genética , Fezes/parasitologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Malária Vivax/diagnóstico , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Adulto JovemRESUMO
The bacterial flora from leishmanial ulcers was studied. The aerobic species Staphylococcus aureus and Pseudomonas aeruginosa were found most frequently. Evaluation of the sensitivity of these species to antibiotics showed that 100% of these isolates of Staphylococcus aureus were sensitive to vancomycin, amikacin and chloramphenicol, while 100% of the isolates of Pseudomonas aeruginosa were sensitive to amikacin, gentamicin and tobramycin. These species were generally resistant to penicillins and tetracycline.
Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Leishmaniose Cutânea/microbiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Adulto JovemRESUMO
The results from a field study on autochthonous visceral leishmaniasis on the island of São Luís are presented. This study started in 2004 and finished in 2006 and had the aim of ascertaining the determinant epidemiological and clinical characteristics of this endemic disease. Two hundred ninety nine autochthonous cases were analyzed, of which 83.6% were children younger than 9 years old and 54.1% were male. The disease occurred in all months of the year, with a peak in June. The coefficient of incidence decreased from 46.1 to 35.2 cases per 100,000 inhabitants over the years studied. The diagnosis was confirmed by laboratory tests in 93.3% of the cases. The treatment of choice was based on N-methylglucamine, with a cure rate of 96.1%. The mean lethality rate was 3.7%. Because of the absence of systematic control actions, the authors propose the creation of a specific program to be developed by the municipalities under the coordination of the State Department of Health.
Assuntos
Doenças Endêmicas , Leishmaniose Visceral/epidemiologia , Adolescente , Adulto , Animais , Antiprotozoários/uso terapêutico , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/tratamento farmacológico , Masculino , Meglumina/uso terapêutico , Antimoniato de Meglumina , Pessoa de Meia-Idade , Compostos Organometálicos/uso terapêutico , Estações do AnoRESUMO
INTRODUCTION: Malaria caused by Plasmodium vivax species has shown signs of severity, recorded with increasing frequency in the medical literature. This study aimed to characterize the signs of severe malaria by Plasmodium vivax in the State of Maranhão, Brazil. METHODS: A descriptive cohort study of patients assisted in the field and a historical and concurrent study of a series of cases among hospitalized patients were undertaken to identify the clinical and laboratory signs of severity. RESULTS: A total of 153 patients were included in the study, 13 of whom were hospitalized. Males made up the majority, numbering 103 (67.3%). The age of the patients ranged from 10 to 70 years, 92.2% were natives of the State of Maranhão, and 65% of the patients had had malaria before. The average time elapsed between symptom onset and diagnosis among outpatients was three days, while among hospitalized patients this average reached 15.5 days, a statistically significant difference (p=0.001). The parasitemia ranged from 500 to 10,000 parasites/µl in 92.8% of cases. The clinical and laboratory manifestations of severity were vomiting and diarrhea, jaundice, drowsiness, mental confusion, seizures, loss of consciousness, agitation, bleeding, pale skin, coughing and dyspnea, thrombocytopenia, anemia, elevation of nitrogenous compounds, and elevated transaminases and bilirubin. CONCLUSIONS: The monitoring of malaria patients with Plasmodium vivax showed the possibility of aggravation, the intensity of which varied in different circumstances, especially the interval time between falling ill and diagnostic confirmation.