Concurrent Helminthic Infection Protects Schoolchildren with Plasmodium vivax from Anemia

malaria in rural areas in the municipality of Careiro, in the Western Brazilian Amazon. (n = 9). In children without intestinal helminthes, a significant decrease in the hemoglobin during the malarial attack was seen as compared to the baseline concentration. In the survival analysis, no difference was seen in the time (in days) from the baseline cross-sectional to the first malarial infection, between parasitized and non-parasitized children.

New index for the diagnosis of liver fibrosis in Schistosomiasis mansoni

ABSTRACT BACKGROUND Periportal fibrosis is the major pathological consequence of the Schistosoma mansoni infection. OBJECTIVE To evaluate the accuracy of serum markers and to construct an index to assess fibrosis. METHODS Patients (n=116) with schistosomiasis were evaluated by ultrasound scan and measurements of serum levels of aminotransferases, γ-glutamyl transferase, alkaline phosphatase, hyaluronic acid, cytokines and platelets. Ultrasound images were used to evaluate the fibrosis using Niamey's classification and identified 19 patients without periportal fibrosis (patterns A and B), 48 with mild to moderate fibrosis (C and D) and 49 with advanced fibrosis (E and F). RESULTS Using multivariate analysis, a model was created, which involved alkaline phosphatase and platelets and could separate patients with different patterns of fibrosis. This index showed a better performance in separating patients without fibrosis from with advanced periportal fibrosis. The biological index showed an area under the ROC curve of 1.000. Using values below the lowest or above the highest cut-off point, the presence or absence of advanced fibrosis could be predicted in all patients. CONCLUSION The index constructed can be used to separate patients with different patterns of periportal fibrosis, specially to predict advanced fibrosis in schistosomiasis patients

Mean (± standard error of the mean) hemoglobin concentration before (baseline Hb) and during (malarial Hb) the first <i>P. vivax</i> acute attack in 54 schoolchildren followed from April to November 2008, in an endemic area for malaria (Municipality of Careiro, Amazonas, Brazil), according to the helminth detected at stool examination.

<p>Mean (± standard error of the mean) hemoglobin concentration before (baseline Hb) and during (malarial Hb) the first <i>P. vivax</i> acute attack in 54 schoolchildren followed from April to November 2008, in an endemic area for malaria (Municipality of Careiro, Amazonas, Brazil), according to the helminth detected at stool examination.</p

Baseline characteristics of 54 schoolchildren followed from April to November 2008, in an endemic area for malaria (municipality of Careiro, Amazonas, Brazil), according to the helminth detected at stool examination during <i>P. vivax</i>.

<p>Baseline characteristics of 54 schoolchildren followed from April to November 2008, in an endemic area for malaria (municipality of Careiro, Amazonas, Brazil), according to the helminth detected at stool examination during <i>P. vivax</i>.</p

Correlation between parasitemia and hemoglobin.

<p>Correlation between parasitemia and hemoglobin during the first malarial attack in children without helminthes (A) and with helminthes (B).</p