Abstrat

Background: the search for predictors of malaria outcome is essential, because a successful, inexpensive, fast and easy to measure predictive test, with minimal infrastructure requirements or specialized training, can be used in malaria endemic environments to reduce serious outcomes and reducing the impact of the disease in poor countries like Angola. Objective: analyze whether vital signs and biochemical markers can be easily predictors of malaria outcome. Methodology: the study was a cross-sectional study and quantitative approach in 194 patients hospitalized for malaria evaluated in five of the seven days of follow-up. Descriptive statistics were computed using the SPSS v20.0 statistical programs and graphs in the Sigmaplot 12.0. Results: of the 194 patients followed, 68 were discharged, 22 died and 104 remained hospitalized after 7 days of follow-up, the mean parasitemia value was higher among patients whose outcome was death (2,909 p/mm3, SD=45) when compared to patients who were discharged (2,258 p/mm3, SD=3,301) and patients who remained hospitalized at the end of the study (1,269, SD=1,557), the mean of parasitemia at the end of the study was less than 60 p/mm3. The highest mean of creatinine was observed in patients who died both on admission (3.7 mg/dL, SD=1.8), compared to patients who remained in hospital (1.8 mg/dL, SD=2.3) and patients were discharged from the hospital (1.5 mg/dL, SD=1.9), however, although there were some changes over the follow-up period, the final mean creatinine of the study was greater than 1.6 mg/dL in all groups and the highest among those who had died (2.8 mg/dL, SD=1.8). Patients who died had a higher mean urea value at admission (78.3 mg/dL, SD=54.9), compared with patients who had been hospitalized (52.3 mg/dL, SD=41.7) and patients were discharged from hospital (48.1 mg/dL, SD=44.9), however, although there were some changes over the follow-up period, the final mean urea in all groups was greater than 44 mg/dL in all groups, especially in patients, died (74 mg/dL, SD=56). The highest mean temperature value was observed in patients who died (37.7ºC, SD = 1.7), compared to the temperature of hospitalized patients (37ºC, SD = 1.2) and patients who were discharged from hospital (36.8ºC , SD = 1.2), at the end of the study, the final mean temperature in all groups was above 36.6 ºC. Another vital sign that presented a higher mean of greater value in patients who died were respiratory cycles (22.7 cycles/min, SD=3.7), compared to the temperature of hospitalized patients (21.6 cycles/min, SD=4.1) and patients discharged from hospital (21.2 cycles/min, SD=3.5), at the end of the follow-up the final average of respiratory cycles in all groups was greater than 21.1 cycles/min. The mean weight of patients who were discharged from death was the highest observed in the study (69 kg, SD = 13), when compared to patients who were discharged and who were hospitalized (less than 64.7 kg, SD less than 11.8), at the end of the follow-up, the patients average weight did not change.The highest mean systolic blood pressure value was observed in patients who remained hospitalized (140.9 mmHg, SD=37), however patients who were discharged and patients who died, had similar mean systolic pressure (133.2 mmHg, SD=34) and at the end of the follow-up, the mean systolic pressure in all groups was less than 128 mmHg. Diastolic pressure did not show a big difference between the three groups of patients followed (less than 83 mmHg, SD less than 29) in patients who were discharged, who died, and who remained hospitalized, at the end of the follow-up, the mean pressure diastolic in all groups was less than 79.4 mmHg. The mean oxygen saturation value also did not show much difference between patients who were discharged, who died and who remained hospitalized (greater than 98%, SD less than 3.2), at the end of the follow-up the average desaturation of oxygen in all groups remained above 98.2%. Conclusions: markers such as parasitemia, urea and creatinine, associated with vital signs such as temperature, pulse, stroke cycles, weight and systolic blood pressure seem to be predictors of outcomes in the population studied, especially on admission, however they vary over time and therefore there are needs for further studies to assess the extent to which these predictors are important signs of outcomes. Vital signs such as temperature, pulse, breathing cycles and systolic blood pressure were shown to be initial predictors of outcomes and biochemical markers such as urea and creatinine appeared to be permanent predictors of outcomes, which is why poor countries like Angola where in most hospital units do not offer conditions for carrying out laboratory tests, the use of predictors such as these can make a difference in the medical and medication approach and reduce the impact of malaria on patients’ lives.
Keywords: I. vital signs II. biochemical markers III. easily predictors IV. malaria outcome.

Biography

PhD in Health Sciences by the Graduate Program of the School of Medicine of PONTIFÍCIA UNIVERSIDADE CATÓLICA DO PARANÁ (PUCPR) in 2017. Master’s Degree in Biochemistry and Molecular Biology by the Department of Biochemistry and Molecular Biology at the School of Biological Sciences and Health UNIVERSITY FEDERAL DO PARANÁ (UFPR) in 2014. Postgraduate (Specialization) in Clinical and General Microbiology by the School of Biosciences at PONTIFÍCIA UNIVERSIDADE CATÓLICA DO PARANÁ (PUCPR) in 2012. Postgraduate (Specialization) in Health Surveillance by the FACULDADE DE CIENCES DE WENCESLAU BRAZ (FACIBRA) in 2017. Graduation in Nursing from the SUPERIOR HEALTH SCIENCES INSTITUTE of UNIVERSITY AGOSTINHO NETO (ISCISA/UAN) in 2010. Graduation in Pedagogy from the FACULTY OF SCIENCES OF WENCESLAU BRAZ (FACIBRA) in 2017. He is post-doctoral student in Health Sciences at the School of Medicine of PONTIFÍCIA UNIVERSIDADE CATÓLICA DO PARANÁ (PUCPR). He is currently a professor at the INSTITUTO SUPERIOR DE HEALTH SCIENCES/UNIVERSIDADE AGOSTINHO NETO. He has experience in the area of General Nursing, with an emphasis on Urgent and Emergency Care, Public Health and Intensive Care. He has experience in service administration and head of nursing teams, especially in Urgent and Emergency Care and has also worked in intensive care. He has experience in Biochemistry and Molecular Biology and General Microbiology, working mainly in teaching, laboratory research and hospital care. He works with research projects focused on comorbidity and mortality in malaria, Acute Kidney Injury in malaria, CKD, Polymorphism of blood groups and susceptibility to malaria, sickle cell anemia and malaria and other projects.

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