Factors contributing to anaemia after uncomplicated Plasmodiumfalciparum malaria in children

The pathogenesis of Plasmodium falciparum malaria in humans: insights from splenic physiology

“…Indeed, because the retention of rings in the spleen corresponds to the clearance of circulating parasites, it likely reduces the speed of parasite load increase and therefore the pace at which infection proceeds. This connection between innate retention of rings, on the one hand, and innate retention of uRBCs, on the other, is perfectly in line with the observations that, in naïve or poorly immune subjects, splenomegaly correlates with a decreased hematocrit or hemoglobin level, 8,30,41 and that duration of fever (from onset to diagnostic) is longer when anemia is present 41,77 …”

“…30 Second, parasitemia is lower in children with severe malarial anemia than in those with cerebral malaria, 41 despite the longer duration of fever in the former. 30,41,77 The hypothesis that age modulates the stringency of splenic retention of rings and uRBCs reconciles more epidemiologic observations than does the lack of a cerebral receptor in infants. 34 It predicts that the risk of cerebral malaria increases and the risk of severe malarial anemia decreases as children grow older, 78 strongly suggesting that the same mechanism may altogether precipitate severe malarial anemia and protect against cerebral malaria.…”

Therapeutic Efficacy and Effects of Artemether-Lumefantrine and Artesunate-Amodiaquine Coformulated or Copackaged on Malaria-Associated Anemia in Children with Uncomplicated Plasmodium falciparum Malaria in Southwest Nigeria

“…In addition, recovery from the total malaria-attributable fall in hematocrit 28,29 (defined as the time interval between hematocrit levels on days 3 and 28 in this study, a time when no further increases in hematocrit levels were seen in the absence of malaria infection) seems to be shorter than that reported in the same area when monotherapies were used (approximately 5 weeks). 29 This would suggest that, compared with non-ACTs, ACTs may hasten recovery in malaria-associated anemic children from this endemic area.…”

Risk Factors for Gametocyte Carriage in Uncomplicated Falciparum Malaria in Children before and after Artemisinin-Based Combination Treatments

“…Despite rapid clearance of asexual parasitaemia by ACTs, failure to control anaemia in an endemic setting may not result in full benefits from their use. Anaemia is multifactorial in endemic settings [36,37], and although the anaemia of malaria frequently results from haemolysis secondary to P. falciparum infections of longer duration, its association with hyperparasitaemia and young age is associated with an increased risk of gametocyte carriage [15,38,39]. If artemisinin drugs are associated with rapid clearance of parasitaemia and low gametocyte carriage [40,41], the role of anaemia and efforts to reduce the burden of malaria-associated anaemia require urgent attention.…”