Prevalence and dynamic changes in lung ultrasound findings among adults with uncomplicated malaria and controls in the Amazon basin, Brazil
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Prevalence and dynamic changes in lung ultrasound findings among adults with uncomplicated malaria and controls in the Amazon basin, Brazil. / Wegener, Alma; Holm, Anna E; Gomes, Laura C; Lima, Karine O; Matos, Luan O; Vieira, Isabelle V M; Kaagaard, Molly Dam; de Souza, Rodrigo Medeiros; Hviid, Lars; Guimarães Lacerda, Marcus Vinícius; Vestergaard, Lasse S; Farias Marinho, Claudio Romero; Platz, Elke; Biering-Sørensen, Tor; Silvestre, Odilson M; Brainin, Philip.
I: American Journal of Tropical Medicine and Hygiene, Bind 106, Nr. 6, 2022, s. 1637-1645.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Prevalence and dynamic changes in lung ultrasound findings among adults with uncomplicated malaria and controls in the Amazon basin, Brazil
AU - Wegener, Alma
AU - Holm, Anna E
AU - Gomes, Laura C
AU - Lima, Karine O
AU - Matos, Luan O
AU - Vieira, Isabelle V M
AU - Kaagaard, Molly Dam
AU - de Souza, Rodrigo Medeiros
AU - Hviid, Lars
AU - Guimarães Lacerda, Marcus Vinícius
AU - Vestergaard, Lasse S
AU - Farias Marinho, Claudio Romero
AU - Platz, Elke
AU - Biering-Sørensen, Tor
AU - Silvestre, Odilson M
AU - Brainin, Philip
PY - 2022
Y1 - 2022
N2 - Malaria patients are at risk of cardiopulmonary complications but diagnosis and management can be difficult in resource-limited settings. B-lines on lung ultrasound (LUS) mark changes in lung density; however, little is known about their role in malaria. We aimed to examine the prevalence of B-lines in adults with malaria at baseline and follow-up compared with controls in the Amazon Basin. We also examined the relationship between B-lines and left ventricular ejection fraction. We performed eight-zone LUS, echocardiography, and blood smears in 94 adults (mean age 40 years, 54% men) with uncomplicated malaria and 449 controls without heart failure, renal insufficiency or lung disease (mean age 41 years, 38% men). Examinations of adults with malaria were repeated after antimalarial treatment, corresponding to a median of 30 days (interquartile range [IQR] 27-39). Adults with malaria suffered from Plasmodium vivax (N = 70, median 2,823 [IQR 598-7,698] parasites/μL) or P. falciparum (N = 24, median 1,148 [IQR 480-3,128] parasites/μL). At baseline, adults with malaria more frequently had ≥ 3 B-lines (summed across eight zones) compared with controls (30% versus 2%, P value < 0.001), indicating higher lung density. When examinations were repeated, only 6% of adults with malaria had ≥ 3 B-lines at follow-up, which was significant lower compared with baseline (median reduction 3 B-line; P value < 0.001). B-lines were not significantly associated with left ventricular ejection fraction in adults with malaria. In conclusion, B-lines detected by LUS were more frequent in adults with uncomplicated malaria compared with controls and decreased after completed antimalarial treatment.
AB - Malaria patients are at risk of cardiopulmonary complications but diagnosis and management can be difficult in resource-limited settings. B-lines on lung ultrasound (LUS) mark changes in lung density; however, little is known about their role in malaria. We aimed to examine the prevalence of B-lines in adults with malaria at baseline and follow-up compared with controls in the Amazon Basin. We also examined the relationship between B-lines and left ventricular ejection fraction. We performed eight-zone LUS, echocardiography, and blood smears in 94 adults (mean age 40 years, 54% men) with uncomplicated malaria and 449 controls without heart failure, renal insufficiency or lung disease (mean age 41 years, 38% men). Examinations of adults with malaria were repeated after antimalarial treatment, corresponding to a median of 30 days (interquartile range [IQR] 27-39). Adults with malaria suffered from Plasmodium vivax (N = 70, median 2,823 [IQR 598-7,698] parasites/μL) or P. falciparum (N = 24, median 1,148 [IQR 480-3,128] parasites/μL). At baseline, adults with malaria more frequently had ≥ 3 B-lines (summed across eight zones) compared with controls (30% versus 2%, P value < 0.001), indicating higher lung density. When examinations were repeated, only 6% of adults with malaria had ≥ 3 B-lines at follow-up, which was significant lower compared with baseline (median reduction 3 B-line; P value < 0.001). B-lines were not significantly associated with left ventricular ejection fraction in adults with malaria. In conclusion, B-lines detected by LUS were more frequent in adults with uncomplicated malaria compared with controls and decreased after completed antimalarial treatment.
U2 - 10.4269/ajtmh.21-1107
DO - 10.4269/ajtmh.21-1107
M3 - Journal article
C2 - 35405640
VL - 106
SP - 1637
EP - 1645
JO - Journal. National Malaria Society
JF - Journal. National Malaria Society
SN - 0002-9637
IS - 6
ER -
ID: 313473276