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

A DESGW Search for the Electromagnetic Counterpart to the LIGO/Virgo Gravitational-wave Binary Neutron Star Merger Candidate S190510g

We present the results from a search for the electromagnetic counterpart of the LIGO/Virgo event S190510g using the Dark Energy Camera (DECam). S190510g is a binary neutron star (BNS) merger candidate of moderate significance detected at a distance of 227 ± 92 Mpc and localized within an area of 31 (1166) square degrees at 50% (90%) confidence. While this event was later classified as likely nonastrophysical in nature within 30 hours of the event, our short latency search and discovery pipeline identified 11 counterpart candidates, all of which appear consistent with supernovae following offline analysis and spectroscopy by other instruments. Later reprocessing of the images enabled the recovery of six more candidates. Additionally, we implement our candidate selection procedure on simulated kilonovae and supernovae under DECam observing conditions (e.g., seeing and exposure time) with the intent of quantifying our search efficiency and making informed decisions on observing strategy for future similar events. This is the first BNS counterpart search to employ a comprehensive simulation-based efficiency study. We find that using the current follow-up strategy, there would need to be 19 events similar to S190510g for us to have a 99% chance of detecting an optical counterpart, assuming a GW170817-like kilonova. We further conclude that optimization of observing plans, which should include preference for deeper images over multiple color information, could result in up to a factor of 1.5 reduction in the total number of follow-ups needed for discovery