PMID- 28510633
OWN - NLM
STAT- MEDLINE
DCOM- 20180223
LR  - 20181113
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 65
IP  - 6
DP  - 2017 Sep 15
TI  - Obesity and Diabetes as Risk Factors for Severe Plasmodium falciparum Malaria:
      Results From a Swedish Nationwide Study.
PG  - 949-958
LID - 10.1093/cid/cix437 [doi]
AB  - Background: Noncommunicable diseases and obesity are increasing in prevalence
      globally, also in populations at risk of malaria. We sought to investigate if
      comorbidity, in terms of chronic diseases and obesity, is associated with severe 
      Plasmodium falciparum malaria. Methods: We performed a retrospective
      observational study in adults (>/=18 years of age) diagnosed with malaria in
      Sweden between January 1995 and May 2015. We identified cases through the
      surveillance database at the Public Health Agency of Sweden and reviewed clinical
      data from 18 hospitals. Multivariable logistic regression was used to assess
      associations between comorbidities and severe malaria. Results: Among 937 adults 
      (median age, 37 years; 66.5% were male), patients with severe malaria had higher 
      prevalence of chronic diseases (28/92 [30.4%]) compared with nonsevere cases
      (151/845 [17.9%]) (P = .004). Charlson comorbidity score >/=1 was associated with
      severe malaria (adjusted odds ratio [aOR], 2.63 [95% confidence interval {CI},
      1.45-4.77), as was diabetes among individual diagnoses (aOR, 2.98 [95% CI,
      1.25-7.09]). Median body mass index was higher among severe (29.3 kg/m2) than
      nonsevere cases (24.7 kg/m2) (P < .001). Obesity was strongly associated with
      severe malaria, both independently (aOR, 5.58 [95% CI, 2.03-15.36]) and in
      combination with an additional metabolic risk factor (hypertension, dyslipidemia,
      or diabetes) (aOR, 6.54 [95% CI, 1.87-22.88]). The associations were observed
      among nonimmune travelers as well as immigrants from endemic areas. Conclusions: 
      Comorbidities, specifically obesity and diabetes, are previously unidentified
      risk factors for severe malaria in adults diagnosed with P. falciparum.
      Noncommunicable diseases should be considered in the acute management and
      prevention of malaria.
CI  - (c) The Author 2017. Published by Oxford University Press for the Infectious
      Diseases Society of America.
FAU - Wyss, Katja
AU  - Wyss K
AD  - Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet.
AD  - Emergency Medicine.
AD  - Infectious Diseases, Karolinska University Hospital, Stockholm.
FAU - Wangdahl, Andreas
AU  - Wangdahl A
AD  - Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet.
AD  - Department of Infectious Diseases, Vasteras Central Hospital.
FAU - Vesterlund, Maria
AU  - Vesterlund M
AD  - Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet.
FAU - Hammar, Ulf
AU  - Hammar U
AD  - Unit of Biostatistics, Department of Epidemiology, Institute for Environmental
      Medicine, Karolinska Institutet, Stockholm, Sweden.
FAU - Dashti, Saduddin
AU  - Dashti S
AD  - Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet.
FAU - Naucler, Pontus
AU  - Naucler P
AD  - Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet.
AD  - Infectious Diseases, Karolinska University Hospital, Stockholm.
FAU - Farnert, Anna
AU  - Farnert A
AD  - Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet.
AD  - Infectious Diseases, Karolinska University Hospital, Stockholm.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases
      Society of America
JID - 9203213
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Body Mass Index
MH  - Comorbidity
MH  - Diabetes Mellitus/*epidemiology/ethnology
MH  - Female
MH  - Humans
MH  - Malaria, Falciparum/*epidemiology/ethnology
MH  - Male
MH  - Middle Aged
MH  - Obesity/*epidemiology/ethnology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Sweden/epidemiology
MH  - Young Adult
PMC - PMC5848256
OTO - NOTNLM
OT  - comorbidity
OT  - diabetes
OT  - noncommunicable diseases
OT  - obesity
OT  - severe malaria
EDAT- 2017/05/17 06:00
MHDA- 2018/02/24 06:00
CRDT- 2017/05/17 06:00
PHST- 2017/02/18 00:00 [received]
PHST- 2017/05/07 00:00 [accepted]
PHST- 2017/05/17 06:00 [pubmed]
PHST- 2018/02/24 06:00 [medline]
PHST- 2017/05/17 06:00 [entrez]
AID - 3826321 [pii]
AID - 10.1093/cid/cix437 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2017 Sep 15;65(6):949-958. doi: 10.1093/cid/cix437.