63812

Evaluation of the pulmonary function in patients with vivax Malaria

Maria D. O. Ohnish 1 ; Ana Maria Revoredo Ventura 2 ; Yumi O. Ohnishi 3 ; Carina G. Sequeira 4 ; Rosana M. F. Libonati 5 ; Valéria M. F. Normando 4 ; Carlos Rodrigo Souza Do Monte 6 ; Geraldo R. Normando Junior 5 ; Tânia Do Socorro Souza Chaves 7 ; Ricardo Luiz Dantas Machado
Download
Favorite this paper

Introduction: Patients with vivax malaria can present several respiratory symptoms without severe forms of the disease. Changes in alveoli gas exchanges, if present, can be indirectly estimated through evaluation respiratory function tests, such spirometry, a tool that may help on the diagnosis and follow up of the lung involvement. Objective: To evaluate the aspects of the pulmonary function in patients with vivax malaria. Casuistic and Methods: Longitudinal, prospective study, approved by Evandro Chagas’ Ethic Committee, performed in 247 individuals, from 15 to 60 years of age, attended in the Malaria Clinical Essay Laboratory of Evandro Chagas Institute. The patients had their malaria diagnosis based on thick blood film and PCR and presented respiratory symptoms. Spirometry was performed in the VITALOGRAPH SPIROTRAC IV device (version Spirotrac 2170, 4.02) which evaluated the Forced vital capacity (FVC), the Forced expiratory volume in the first second (FEV1), the ratio FEV1/FVC and the Midexpiratory Phase (FEF25-75%). The results were compared to the adequate population values (Knudson’s table, Pereira, 2002) and were performed in the patients up to 48h, after diagnosis and between 15th-18th days, after malarial treatment. Results: The mean age was de 35 ± 13.2 years, 69.2% were male. Primary infection occurred in 42.1% and re-infection in 57.9%. The mean disease interval time was 7.5 ± 5.9 days. The mean parasitemia was 6.979,25 ± 8.692,22 parasites/ mm3. Cough (55%), breathless “feeling” (44%) and dyspneia (28.7%) were the main observed symptoms, which disappeared after treatment. History of pneumopathy (asthma, bronchitis, and/or bronchiectasis) was reported by 7.7% of the patients. The pulmonary function measurements were normal when compared to the values of Knudson’s Table. The FVC, FEV1 and FEF 25-75% parameters had increase significance values in the control spirometry (p<0.05, Mann-Whitney test), though on the limit of normality. Conclusion: Respiratory complaints may be observed in vivax malaria without complication, with plentiful response after malarial treatment. In comparison, the patients with vivax malaria had low values of function respiratory tests evaluated by spirometry on the onset of the diagnosis, especially FEF 25-75%, with increase on their values in the next evaluation, both in the range of normality.