Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out

The flora and vegetation of rocky outcrops in three municipalities in the northern region of Ceará, Brazil: phytosociological characterization

Veja material suplementar em <https://doi.org/10.6084/m9.figshare.5915233.v2O presente estudo teve como objetivo identificar a flora e a vegetação dos afloramentos rochosos isolados e de baixa altitude (lajedos), na vegetação de Caatinga Arbustiva Aberta, que se encontram nos municípios de Sobral, Groaíras e Santa Quitéria, no estado do Ceará, Brasil e propor uma classificação fitossociológica para estas comunidades xerófilas. Foram definidas cinco áreas de coleta de dados com elevada proporção de rochas expostas (> 80%) onde as excursões de campo decorreram em março de 2014 e 2015 (3º56’S e 40º23’W, 4º01’S e 40º05’W, 4º07’S e 40º08’W, 4º09’S e 40º09’W e 4º03’S e 40º00’W). No estudo da vegetação aplicou-se os métodos TWINSPAN (two-way indicator species analysis) e o clássico sigmatista de Braun-Blanquet. As áreas mínimas dos inventários fitossociológicos variaram de 8 a 16 m2. Foram coletadas as espécies vegetais que crescem em fissuras, fendas e ilhas de vegetação que se encontram em afloramentos rochosos. Foram registradas 88 espécies, distribuídas em 59 gêneros e 30 famílias botânicas. Fabaceae foi a família que se destacou em riqueza específica (20 spp.), seguida por Poaceae (dez spp.), Euphorbiaceae (sete spp.) e Convolvulaceae (seis spp.). Quanto ao endemismo foram registradas, em vegetação rupestre, 19 espécies endêmicas para o Brasil. Na análise fitossociológica da vegetação propôs-se estudar a comunidade de Pilosocereus gounellei (FA.C.Weber) Byles & Rowley e Encholirium spectabile Mart. ex Schult. & Schult.f. e a de Crateva tapia L. e Combretum leprosum Martinfo:eu-repo/semantics/publishedVersio