Anaemia is amongst the major complications of malaria, a major public health problem in the Amazon Region in Latin America. We examined the haemoglobin (Hb) concentrations of malaria-infected patients and compared it to that of malaria-negative febrile patients and afebrile controls. The haematological parameters of febrile patients who had a thick-blood-smear performed at an infectious diseases reference centre of the Brazilian Amazon between December 2009-January 2012 were retrieved together with clinical data. An afebrile community control group was composed from a survey performed in a malaria-endemic area. Hb concentrations and anaemia prevalence were analysed according to clinical-epidemiological status and demographic characteristics. In total, 7,831 observations were included. Patients with Plasmodium falciparum infection had lower mean Hb concentrations (10.5 g/dL) followed by P. vivax-infected individuals (12.4 g/dL), community controls (12.8 g/dL) and malaria-negative febrile patients (13.1 g/dL) (p < 0.001). Age, gender and clinical-epidemiological status were strong independent predictors for both outcomes. Amongst malaria-infected individuals, women in the reproductive age had considerably lower Hb concentrations. In this moderate transmission intensity setting, both vivax and falciparum malaria are associated with reduced Hb concentrations and risk of anaemia throughout a wide age range.

Objectives: To determine the inappropriate admissions and days of hospitalization using Appropriateness Evaluation Protocol (AEP) in the Medicine Department at the Hospital Nacional Cayetano Heredia (HNCH). Material and Methods: Descriptive and retrospective cross-sectional study. Medical records of inpatients at the Department of medicine of HNCH during November 1999 and January 2000 were reviewed. AEP was used in order to determine the appropriateness of the admission, 2 randomized days of hospitalization and the day before discharge. Chi square test was used to find association with demographic and inpatient characteristics, assumed p<0.05 as statistically significant. Results: Of the 117 reviewed medical records, 5.98% of the admissions and 27.38% of the days of hospitalization were inappropriate. 48.72% of the days before discharge and 15.98% of the randomized days were inappropriate (p<0.05). Inverse association between admissions by emergency and the inappropriateness of the admission was found. The inappropriate admissions of inpatients < 65 years age group generated greater proportion of inappropriate days. Conclusion: The percentage of the inappropriateness (admission & hospitalization days) at the Department of medicine of HNCH are similar to the lowest reported values of the international literature, in developed countries. We emphasized the importance of medical behavior and faster and better accessibility in the accomplishment of administrative procedures to control the unnecessary prolongation of the hospitalizations, specially in the days previous to discharge. ( Rev Med Hered 2001; 12: 85-91 ).

Objetivos: Determinar la proporción de admisiones y días de hospitalización inapropiados mediante el protocolo para la evaluación de lo apropiado (AEP) en el Departamento de Medicina del Hospital Nacional Cayetano Heredia (HNCH). Material y Métodos: Estudio transversal descriptivo de corte retrospectivo. Se revisó las historias clínicas de los hospitalizados en el servicio de medicina del HNCH entre noviembre de 1999 y enero del 2000. Se aplicó el AEP para determinar lo apropiado de la admisión, de 2 días de hospitalización aleatorios y del día previo al alta. Se utilizó la prueba chi cuadrado para encontrar asociación con las características demográficas y de hospitalización, considerando p<0.05 como estadísticamente significativo. Resultados: De 117 historias revisadas, el 5.98% de las admisiones y el 27.38% de los días de hospitalización fueron inapropiados. Fueron inapropiados el 48.72% de los días previos al alta y el 15.98% de los días aleatorios (p<0.05). Se encontró asociación inversa entre admisión por emergencia y lo inapropiado de la hospitalización. Las admisiones inapropiadas y el grupo <65 años generaron mayor proporción de días inapropiados. Conclusión: Los porcentajes de lo inapropiado (admisión y días de hospitalización) en el servicio de medicina del HNCH concuerdan con los valores más bajos reportados en la literatura internacional de países desarrollados. Resaltamos la importancia del comportamiento médico y de la mejor accesibilidad y rapidez en la realización de trámites administrativos para controlar la prolongación innecesaria de las hospitalizaciones, especialmente en los días de hospitalización previos al alta. (Rev Med Hered 2001; 12: 85-91).