↓ Skip to main content

Microvascular obstruction and endothelial activation are independently associated with the clinical manifestations of severe falciparum malaria in adults: an observational study

Overview of attention for article published in BMC Medicine, May 2015
Altmetric Badge

About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (80th percentile)

Mentioned by

twitter
12 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
30 Dimensions

Readers on

mendeley
31 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Microvascular obstruction and endothelial activation are independently associated with the clinical manifestations of severe falciparum malaria in adults: an observational study
Published in
BMC Medicine, May 2015
DOI 10.1186/s12916-015-0365-9
Pubmed ID
Authors

Josh Hanson, Sue J. Lee, Md Amir Hossain, Nicholas M. Anstey, Prakaykaew Charunwatthana, Richard J. Maude, Hugh W. F. Kingston, Saroj K. Mishra, Sanjib Mohanty, Katherine Plewes, Kim Piera, Mahtab U. Hassan, Aniruddha Ghose, M. Abul Faiz, Nicholas J. White, Nicholas P. J. Day, Arjen M. Dondorp

Abstract

Microvascular obstruction and endothelial dysfunction have both been linked to tissue hypoperfusion in falciparum malaria, but their relative contributions to the disease's pathogenesis and outcome are unknown. Microvascular blood flow was quantified in adults with severe falciparum malaria on their admission to hospital; plasma biomarkers of endothelial function were measured simultaneously. The relationship between these indices and the patients' clinical findings and in-hospital course was examined. Microvascular obstruction was observed in 119/142 (84 %) patients; a median (interquartile range (IQR)) of 14.9 % (6.6-34.9 %) of capillaries were obstructed in patients that died versus 8.3 % (1.7-26.6 %) in survivors (P = 0.039). The proportion of obstructed capillaries correlated with the estimated parasite biomass (rs = 0.25, P = 0.004) and with plasma lactate (rs = 0.38, P <0.0001), the strongest predictor of death in the series. Plasma angiopoietin-2 (Ang-2) concentrations were markedly elevated suggesting widespread endothelial activation; the median (IQR) Ang-2 concentration was 21.9 ng/mL (13.4-29.4 ng/mL) in patients that died versus 14.9 ng/mL (9.8-29.3 ng/mL) in survivors (P = 0.035). Ang-2 concentrations correlated with estimated parasite biomass (rs = 0.35, P <0.001) and plasma lactate (rs = 0.37, P <0.0001). Microvascular obstruction and Ang-2 concentrations were not significantly correlated with each other (rs = 0.17, P = 0.06), but were independently associated with plasma lactate (P <0.001 and P = 0.002, respectively). Microvascular obstruction and systemic endothelial activation are independently associated with plasma lactate, the strongest predictor of death in adults with falciparum malaria. This supports the hypothesis that the two processes make an independent contribution to the pathogenesis and clinical manifestations of the disease.

Twitter Demographics

The data shown below were collected from the profiles of 12 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 1 3%
Denmark 1 3%
Belgium 1 3%
Canada 1 3%
Unknown 27 87%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 39%
Student > Ph. D. Student 6 19%
Student > Bachelor 5 16%
Unspecified 2 6%
Student > Postgraduate 2 6%
Other 4 13%
Readers by discipline Count As %
Medicine and Dentistry 15 48%
Agricultural and Biological Sciences 7 23%
Biochemistry, Genetics and Molecular Biology 3 10%
Unspecified 3 10%
Immunology and Microbiology 2 6%
Other 1 3%

Attention Score in Context

This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 July 2015.
All research outputs
#2,079,920
of 12,494,919 outputs
Outputs from BMC Medicine
#1,217
of 1,999 outputs
Outputs of similar age
#46,518
of 233,667 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 12,494,919 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,999 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 34.1. This one is in the 38th percentile – i.e., 38% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 233,667 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 80% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them