Acute haemolysis in childhood falciparum malaria

Abstract

Acute haemolysis associated with clinical episodes of high-level Plasmodium falciparum parasitaemia was studied in 20 children from an holoendemic area (coastal Tanzania). The change in blood haemoglobin (Hb) concentration ranged from -46 to g/L during the 72-h observation period and was linearly related to maximum parasitaemia. Balance studies between loss of blood Hb, increase in plasma Hb and appearance of Hb in the urine indicated that extravascular clearance of red cells was the predominant mode of erythrocyte clearance. Most subjects, however, showed minor signs of intravascular haemolysis. The plasma Hb was << 1% of blood Hb and haemoglobinuria was detected in 14/20 children but the excretion of Hb in urine was < 0.5% of total Hb loss. Haemoglobinuria was, however, a marker of severe haemolysis, since the maximum blood Hb loss in children without haemoglobinuria was 10 g/L. Erythrocyte-bound opsonins known to induce erythrophagocytosis, i.e., complement C3c fragments and autologous IgG, were increased in all patients. In the patients with major haemolysis, the changes correlated to the haemolysis over time. Hence, a similar mechanism for predominantly extravascular erythrocyte clearance may be operative in acute malarial anaemia, normal erythrocyte senescence and other forms of acute haemolysis.

The etiology of severe anemia in a village and a periurban area in Mali

“…A similar correlation between admission parasitemia and the level of anemia has been described in Thailand 7 and Tanzania. 8 Previous studies have demonstrated a reduction in the incidence of severe and moderate to severe anemia by 50% or more in the setting of intermittent treatment with antimalarial drugs, 9,10 although rebound of high parasitemia occurred after discontinuation of therapy. 11 Why did severe anemia not develop in the 14 other children younger than 3.2 years of age who had parasitemia equal to or more than 0.1 ϫ 10 12 /L (Ն 100 000/L) ( Table 2)?…”

Do ownership of mosquito nets, dwelling characteristics and mothers’ socio-economic status influence malaria morbidity among children under the age of 5 in Cameroon?

“…Some studies have, therefore, emphasized adequate nutrition as panacea for the disease infection among children [32]. Similarly, there may be a significant interaction between a mother's education and family wealth.…”

Wild African great apes as natural hosts of malaria parasites: current knowledge and research perspectives

“…Higher levels of blood parasitaemia are likely to at least induce higher degrees of anaemia (Kotepui et al, 2015;Oni and Oguntibeju, 2006), which in turn could cause morbidity or even mortality. Anaemia is actually recognised as one of the major causes of morbidity and mortality related to malaria in young children and pregnant women (Ekvall et al, 2001). Moreover, in humans, malaria during pregnancy can have deleterious consequences for the pregnancy's outcome and the infant's health (Desai et al, 2007;Guyatt and Snow, 2001).…”