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Association of severe malaria with ABO-blood group types in an endemic zone of Colombia. Asociación de malaria severa con tipo de grupo sanguíneo ABO en una zona endémica de Colombia. D en Patología. Correo electrónico: aherrera ces. Investigadora Instituto Colombiano de Medicina Tropical. Grupo de investigación Instituto Colombiano de Medicina Tropical. Universidad CES.
Introduction: malaria is considered are relationships good for you of the most important tropical illnesses in public health causing millions of infections and deaths each year. Many studies have tried to establish an association between the severe form of the disease and the ABO-blood group type.
In Colombia, a country with large endemic zones for malaria there are not types of association in epidemiology studies or statistic data about this possible association. Methods: a retrospective case-control study of patients with severe and uncomplicated malaria in types of association in epidemiology endemic zone of Apartadó, Colombia, was performed between January and June Only the clinical records with blood group ABO and Rh classification were included. Results: a total sample of 92 patients was obtained: 49 with severe malaria and 43 with uncomplicated malaria.
From the total sample, Of the patients with diagnosis of severe malaria, The more frequent parasite species types of association in epidemiology Plasmodium falciparum. Severe malaria was more frequent among patients classified with blood group O Conclusion: even though severe malaria was more frequent among patients classified with blood group O and positive Rh, an association between blood group and severe malaria could not be established. The controversial association of these variables previously found in other populations could be probably explained by the demographic distribution and characteristics of those.
Muchos estudios han tratado de establecer una asociación entre la forma grave de la enfermedad y la clasificación sanguínea ABO. En Colombia, un país con grandes zonas endémicas de malaria, no existen suficientes estudios y datos estadísticos acerca de esta posible asociación. Objetivo: identificar pacientes con trastornos de la deglución, en una unidad de cuidados especiales y caracterizar las causas directas de dichos trastorno.
Métodos: se realizó un estudio de casos y controles de pacientes con malaria severa y no complicada en la zona endémica de Apartadó, Colombia y ejecutado entre enero de y junio de Sólo las historias clínicas con información acerca de la clasificación sanguínea ABO o Rh fueron incluidas. Resultados: la muestra total fue de 92 pacientes, 49 con malaria grave y 43 con malaria no complicada. Conclusión: aunque la malaria severa fue mas frecuente en pacientes con grupo sanguíneo O y Rh positivo, una asociación entre la severidad de la malaria y la clasificación sanguínea no pudo ser establecida.
Malaria is considered a worldwide major public health problem 1 as it is the most important parasite disease affecting humans and causing millions of deaths each year 2. In tropical and subtropical regions of the world, it is estimated that malaria is responsible for to millions of infections and 2 to 3 millions of deaths per year 3 ; being considered as one of the main health problems in regions like Africa, India, Southeast of Asia, and South America 4.
Given the optimal environmental conditions for malaria transmission among different territories of Colombia, the country is considered as one of the endemic zones in the world 1,3. The latest, is the parasite widely associated with a more severe presentation of the disease 1,2. However, besides the parasite species, the clinical presentation and severity of the disease are influenced by the geographic zone, demographic characteristics and host susceptibility 5.
Types of association in epidemiology pathophysiological mechanisms have been postulated to explain host susceptibility for parasite colonization and clinical presentation of the disease. Several authors have stated that while groups A, B, and O seem to be equally susceptible to the infection, group AB show less propensity to infections. Additionally, it is suggested that groups A and O exhibit less colonization by P.
In a systematic review published init was reported that while in 7 different studies a significant association between P. About Rh classification, many studies have found a protective association between negative Rh and the susceptibility to P. In terms of the severity of the disease, it has been found that severe malaria frequency is in linear relation with parasite concentration and intra-erythrocyte rosettes formation mainly by P. Some studies have found that P.
At the epidemiological level and only considering the clinical studies, a clear association between severe malaria and blood group classification has not been established Some comparative studies have demonstrated differences in terms of blood group types and the differences between correlation and causation of severe malaria concluding that patients with group O could be more resistant to the infection by P.
However, other studies have failed to demonstrate this association 16, In a recent publication, Cserti and Dzik suggested that the controversial association between severe malaria types of association in epidemiology ABO blood groups is closely related to the geographic distribution of the different blood groups among the endemic zones These studies have been performed in many tropical territories affected by malaria around the world, however, in Colombia, a country with large endemic zones; there are no many similar types of association in epidemiology or statistic data about this alleged association.
The clinical records types of association in epidemiology patients with malaria and ABO blood group and Rh how should relationships make you feel were included. A retrospective case-control study of patients diagnosed with severe malaria and uncomplicated malaria during this period was performed.
Neonatal malaria was used as exclusion criteria. The cases of severe malaria were defined by the presence of one or more of the following criteria based on the report published by the World Health Organization WHO, 18 and adapted by the researchers keeping into account the criteria established in Colombia by the Ministry of Social Protection for malaria falciparum parasitemia and severe anemia 19and for severe trombocitopenia according to the definition published by Tobon et al.
Information about demographic variables, blood group classification, and parasite type and meaning of in nepali economic tests values was collected from each clinical record of both groups: uncomplicated malaria and severe malaria. Bivariated analysis to evaluate differences between numeric variables between cases and controls was performed through the U Mann-Whitney test and to evaluate the association between types of association in epidemiology variables a Chi-square test was performed.
The sample was conformed by 49 patients in the group of cases and 43 in the control group. Median age of the total sample was 20 years interquartile range 5. The frequency distribution of the what is meant by tangible personal property ABO blood groups of the total sample was: group O In terms of Rh classification, The more frequent parasite in the total sample was P.
Mixed malaria by both parasites was present in 2 patients 2. The demographic and clinical characteristics of patients of cases and control groups are displayed in table 1. There were no cases diagnosed by severe hypoglycemia. There was one death caused by severe malaria. The bivariated analysis to establish association between severity of the disease and the ABO and Rh blood group classification did not show statistical significance for any of the blood types.
With regard to the association of the rest of variables with the severity of malaria, a statistically significant association between this one and sex was found OR 2. Examining the association of the severity of the disease and range of age, it was observed that severe malaria affects significantly more those patients between one and 12 years of age OR 5. Also, there was significant association with the parasite species being P.
Pregnancy also presented a significant association with severe malaria OR 0. As in the rest of patients of the sample, in pregnant women, severe malaria did not show significant association with the ABO blood Group classification. Evaluating parasite species and its possible association with any blood type, it was found that for infection with each of both parasites: P. Several reports in the literature establish association between the blood classification system ABO and malaria; specifically between group AB and severe malaria and refer that people with blood type O are relatively resistant to develop severe malaria by P.
Faciparum 8,9,14, In the present study, an association between blood group and severe malaria was not found. These findings are similar to what was how to know when a casual relationship is over by Montoya et al. Falciparum or P. Vivax in 4 different ethnic groups in Colombia 9.
Alike, Cavasin et al. In another Amazonic area, Beiguelman et al. In the present study, In the present study no cases of severe malaria had blood type B. In uncomplicated malaria patients the predominant blood type was also O, while Pathirana's reported These findings support more the idea that the alleged association between blood type and severity of malaria depends on the demographic distribution and characteristics of the studied population, as every region in the types of association in epidemiology seems to have different ABO phenotype distribution.
The demographic characteristics of the evaluated population in the present study suggest in general a higher frequency of the disease in women specially those in their third trimester of pregnancy. The bivariated what are the 8 stages of development how do they differ from each other indicated that males are at more risk types of association in epidemiology developing severe malaria, however, there are not physiopatological mechanisms that could explain this association.
This situation could be explained from the public health system point of view, as the strict prenatal assistance and control system of our country assures that women in fertile age and during pregnancy could be detected rapidly in the early phases of the disease avoiding the progression of malaria to a severe stage. Therefore, the ratio of 20 of 29 males affected by severe malaria contrast with the ratio of 29 of 63 females with the same diagnosis probably indicating that even though in this study malaria is more frequent among women, its progress to a severe stage is less frequent in those as well.
Another explanation could be the fact that pregnant women with uncomplicated malaria are hospitalized and given special care due to their condition, therefore types of association in epidemiology complications of their disease The median age of affected patients by the severe disease was constituted by young adults, but after performing the analysis by groups of age, a high frequency of severe malaria in the age group between years was evident. This is possibly due to the susceptibility of children to experience a more severe types of association in epidemiology of the disease given the poor immunological and nutritional conditions of this population In agreement with the epidemiological data found in our country and previously described in the literature, in the total sample of this study, the most frequent parasite for non complicated malaria found in this endemic zone was P.
Only 2 patients presented mixed infection by P. The majority of severe cases of malaria were diagnosed by the presence of severe anemia given by highly compromised levels of hemoglobin and hematocrit. This contrast with the results obtained by Tobón et al. However, this finding is in agreement with other studies where severe anemia is reported as one of the most frequent parameters for the diagnose of severe malaria in other populations probably due to their geographic conditions Coherent also with the reported in the literature, there were not cases of severe malaria diagnosed by severe hypoglycemia In the present study, although severe malaria was more frequent among patients classified with blood group O Botero D, Restrepo M.
En: Parasitosis Humanas. Tercera edición. Medellín, Colombia. Malaria and Babesiosis: Diseases caused by red blood cell parasites. En: Harrison's principles of internal medicine. Edición Mc Graw Hill.
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