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Acta Parasitologica

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IMPACT FACTOR 2016: 1.160
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1896-1851
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Volume 61, Issue 2 (Jun 2016)

Issues

Determination of PCT on admission is a useful tool for the assessment of disease severity in travelers with imported Plasmodium falciparum malaria

Elda Righi
  • Corresponding author
  • Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy
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  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Maria Merelli
  • Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy
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/ Alessandra Arzese
  • Microbiology Laboratory Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
  • Department of Experimental Clinical Medicine, University of Udine, Udine, Italy
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  • De Gruyter OnlineGoogle Scholar
/ Paola Della Siega
  • Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy
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/ Claudio Scarparo
  • Microbiology Laboratory Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
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/ Matteo Bassetti
  • Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy
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Published Online: 2016-03-30 | DOI: https://doi.org/10.1515/ap-2016-0055

Abstract

Procalcitonin (PCT) and C-reactive protein (CRP) may be useful to predict complicated forms of malaria. A total of 30 consecutive travelers diagnosed with Plasmodium falciparum malaria over a two-year period were included in the study. Patients with complicated Plasmodium falciparum malaria showed higher levels of parasitemia (P = 0.0001), PCT (P = 0.0018), CRP (P = 0.0005), bilirubinemia (P = 0.004), and a lower platelet count (P<0.0001) compared with patients with uncomplicated forms. PCT levels above 5 ng/mL showed the highest value of specificity (0.86) and positive predictive factor (0.67) among other parameters, and equal sensitivity (0.67) was displayed by CRP levels above 150 mg/dl. None of the patients with complicated malaria showed PCT levels within normal limits (<0.5 ng/ml). Both PCT and CRP correlated with parasitemia (P<0.001) and showed areas under ROC curve of 0.83. At multivariate analysis, only PCT was associated with an increased risk of complicated malaria (OR 8.2, IC 95% 1.2–57.2, P = 0.03). The determination of PCT on admission showed better results compared to CRP, platelet count, and bilirubinemia and can be useful in non-endemic areas for the initial clinical assessment of disease severity in travelers with Plasmodium falciparum malaria.

Key words: Complicated P. falciparum malaria; procalcitonin; C-reactive protein; parasitemia; bilirubinemia; platelet count

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About the article


Received: 2015-07-17

Revised: 2015-12-28

Accepted: 2016-01-20

Published Online: 2016-03-30

Published in Print: 2016-06-01


Citation Information: Acta Parasitologica, ISSN (Online) 1896-1851, ISSN (Print) 1230-2821, DOI: https://doi.org/10.1515/ap-2016-0055.

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